Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Urological Society of India, Lucknow 226014, India.
To determine the efficacy and long-term outcome of pyeloplasty in poorly functioning kidneys in the pediatric age group.
Retrospective data analysis was performed on patients who underwent pyeloplasty in 2000-2008. The parameter analyzed was postoperative outcome. Success was defined on the basis of either improvement in symptoms or better drainage on postoperative Tc-99m DTPA renography done after 3 months and yearly thereafter.
A total of 39 patients with a mean age of 8.6 years (4 months to 13 years), and male to female ratio of 3:1, with poor function on isotope renogram (< 30%) were included in the study. Left to right side ratio was 1.3:1. Dismembered pyeloplasty was done in all patients. Laparoscopic pyeloplasty was done in 27 (66.7%) and open in 12 (33.3%) patients. Follow-up renograms were available for 35 patients: 31 showed improvement in drainage and no further deterioration in renal function and 4 showed an obstructed pattern; of these, two patients had significant deterioration in split function and the other two underwent redo pyeloplasty by open technique. At a mean follow up of 41.6 months (8-75), overall success rate was 90%.
Pyeloplasty gives good intermediate-term results in poorly functioning kidneys in the pediatric age group.
Bansal R, Ansari MS, Srivastava A, Kapoor R. Are you the author?
Reference: J Pediatr Urol. 2011 Feb 4. Epub ahead of print.