RESULTS OF PYELOPLASTY IN TREATMENT CONGENITAL HYDRONEPHROSIS IN CHILDREN

Duy Việt Nguyễn1,, Anh Dũng Lê1
1 Vietnam National Children's Hospital.

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Abstract

Aim: describe the results of pyeloplasty in the treatment congenital of hydronephrosis in children. Subject: a retrospective study in patients with hydronephrosis who underwent pyeloplasty by Anderson – Hynes approach, A double J stent was placed perioperatively and extracted approximately one month later, from 1.2016 to 12.2018 in the National Hospital of Pediatrics.  A surgical indication was differential renal function less than 40% or T/2 > 20 min on the affected kidney. Patients were done kidney ultrasound to measure renal-pelvis anterior-posterior diameter before surgery and repeated ultrasound at follow-up. Percent improvement in renal pelvis anterior-posterior diameter was more than 38% which is defined as pyeloplasty successfully. The rate of success and percent improvement in renal pelvis anterior-posterior diameter were evaluated at 6 months, 12 months, and 24 months after surgery. The data were analyzed by the medical statistical software SPSS 20.0, with p < 0.05 statistical significance. Results: there were 145 one-sided hydronephrosis patients who underwent pyeloplasty, 126 of them were included. Among the included children, 77.0% were male and 23.0% were female; left hydronephrosis was 71.4%, and 28,6% hydronephrosis on the right. Percent improvement in renal pelvis anterior-posterior diameter improved statistically significantly at the time of follow-up and the results were 16.6 ± 10.7 mm, 13.7 ± 8.9 mm,  and 11.4 ± 7.2 mm, respectively. Similarly, the success rate increased at the time of follow-up was 73.8%, 86.5%, and 89.7%, respectively, with p < 0.001. The success rate was not related to surgical age and anterior-posterior diameter, which was statistically significant. Conclusion: the success rate was not related to the age of surgery and not to the degree of dilatation of the anterior-posterior diameter of the renal pelvis. Patients with a post-pyeloplasty need to be followed up for at least 24 months and achieved the highest success rate of 89.7%.

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References

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