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Clinico-pathological correlation in duplex system ectopic ureters and ureteroceles: can preoperative work-up predict renal histology?

作者信息

Meneghesso Davide, Castagnetti Marco, Della Vella Manuela, Benetti Elisa, Zucchetta Pietro, Rigamonti Waifro, Murer Luisa

机构信息

Pediatric Nephrology, Dialysis and Transplant Unit, Department of Pediatrics, University Hospital of Padova, Padua, Italy.

出版信息

Pediatr Surg Int. 2012 Mar;28(3):309-14. doi: 10.1007/s00383-011-3032-z. Epub 2011 Nov 30.

DOI:10.1007/s00383-011-3032-z
PMID:22127487
Abstract

PURPOSE

Upper pole histology has been poorly investigated in duplex system ectopic ureters and ureteroceles. We aimed to determine the differences in histology between the conditions, and to identify clinical markers of renal damage.

METHODS

Twenty-two patients undergoing partial nephrectomy between 2001 and 2007 for poorly functioning upper poles associated with ectopic ureters (n = 11) or ureteroceles (n = 11) were considered. Histology was classified into three groups: normal, chronic interstitial nephritis (CIN), and dysplasia. Clinical and radiological variables were compared between the two conditions and between cases with normal and abnormal histology.

RESULTS

Of the 22 upper pole specimens, 9 had normal histology, 8 dysplasia, and 5 CIN. Statistical analysis failed to show any significant difference in preoperative variables or histology between ectopic ureters and ureteroceles, and in preoperative variables between cases with normal and abnormal histology.

CONCLUSIONS

We did not find significant differences in the histology of upper poles associated with ectopic ureters and ureteroceles. Histology was normal in more than one-third of patients, although the poles were poorly functioning. We hypothesize that these poles were hypoplasic rather than dysplasic. We failed to identify predictors of histological damage. Hence, the latter cannot be considered a factor guiding our decision-making.

摘要

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1
Clinico-pathological correlation in duplex system ectopic ureters and ureteroceles: can preoperative work-up predict renal histology?
Pediatr Surg Int. 2012 Mar;28(3):309-14. doi: 10.1007/s00383-011-3032-z. Epub 2011 Nov 30.
2
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Histology of upper pole is unaffected by prenatal diagnosis in duplex system ureteroceles.重复肾系统输尿管囊肿中,上极的组织学不受产前诊断的影响。
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本文引用的文献

1
Management of duplex system ureteroceles in neonates and infants.新生儿和婴儿的双套系统输尿管囊肿的处理。
Nat Rev Urol. 2009 Jun;6(6):307-15. doi: 10.1038/nrurol.2009.82.
2
Clinical and molecular markers of chronic interstitial nephropathy in congenital unilateral ureteropelvic junction obstruction.先天性单侧输尿管肾盂连接部梗阻所致慢性间质性肾病的临床及分子标志物
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Pathogenesis of renal injury in obstructive uropathy.梗阻性尿路病中肾损伤的发病机制。
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Watchful waiting for prenatally detected ureteroceles.对产前检测出的输尿管囊肿进行观察等待
J Urol. 2006 Apr;175(4):1493-5; discussion 1495. doi: 10.1016/S0022-5347(05)00676-2.
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The predictive value of diagnostic imaging for histological lesions of the upper poles in duplex systems with ureteroceles.在伴有输尿管囊肿的双系统中,诊断性影像学对上极组织学病变的预测价值。
BJU Int. 2003 May;91(7):678-82. doi: 10.1046/j.1464-410x.2003.04247.x.
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Can histologic changes of the upper pole justify a conservative approach in neonatal duplex ectopic ureterocele?
Pediatr Surg Int. 2002 Dec;18(8):681-4. doi: 10.1007/s00383-002-0739-x. Epub 2002 Oct 26.
7
Histology of upper pole is unaffected by prenatal diagnosis in duplex system ureteroceles.重复肾系统输尿管囊肿中,上极的组织学不受产前诊断的影响。
J Urol. 2002 Sep;168(3):1123-6. doi: 10.1016/S0022-5347(05)64606-X.
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Toward an etiological classification of developmental disorders of the kidney and upper urinary tract.
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Duplex systems.双工系统。
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Guidelines for standard and diuretic renography in children.儿童标准及利尿肾图检查指南。
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