Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi University, Tıp Fakültesi, Turkey
Approval Date: 2019
Thesis Language: Turkish
Student: Dr. Teymursha Muradi
Supervisor: RAMAZAN KARABULUT
Open Archive Collection: AVESIS Open Access Collection
Abstract:BACKGROUND Herein we report our clinical data and treatment outcomes of pediatric ureteropelvic junction obstruction (UPJO) patients. METHOD We retrospectively reviewed the data of 64 patients who underwent open dismembered pyeloplasty (except one robotic) because of UPJO between 2006 and 2019 at our clinic. Cases were evaluated regarding age, gender, prenatal history, hydronephrosis, pre- and postoperative courses, differential renal functions (DRFs), half-time tracer clearance (½TC), histopathologic results, urinary infection, and reoperations. Anova and Chi-Square tests were used to test the differences between the groups, where p < 0.05 was taken as statistically significant. RESULTS The mean operation age of patients was 46.87 months. forty-seven of these children (73.4%) were male. UPJO was found the right side in 39.1%(n=25), left side in 56.3 %(n=36), and bilaterally in 4.7% (n=3). Antenatal hydronephrosis was detected in 68.8% of patients (n=44). Vesicoureteral reflux demonstrated only 6.3% (n=4). Pre and postoperatively, mean DRFs were 49.7% (21–78%) and 49.2% (20–56%), respectively. All patient t1/2 was higher than 20 minutes. The mean diameter of AP was 21.58 mm (10–62 mm). The mean length of excised specimen was 10,26 mm (3-40 mm), muscular hypertrophy was seen dominantly. Crossing vessel (CV) was IV found in 17.18% (n=11). It was found statistically significant on the left side, higher operation age and female patients. Hydronephrosis was found statistically significant compared to the non-CV patients. There was no difference between the other parameters. Postoperative recurrence was seen in 4 patients (6.2%). CONCLUSION Internal causes play an important role in the etiology of UPJO patients with antenatal diagnosis, and the operation is needed at an earlier age. However, CVs are more common in the etiology of patients who are diagnosed and operated on later.