Department of Urology, Wayne State University School of Medicine, Grand Rapids, MI 49503, USA.
J Pediatr Urol. 2013 Oct;9(5):613-6. doi: 10.1016/j.jpurol.2012.06.002. Epub 2012 Jul 28.
We aimed to determine the duration and associated complications of postoperative urinary leakage in pediatric patients undergoing open, non-stented dismembered pyeloplasty for ureteropelvic junction obstruction.
A retrospective review of 100 patients who underwent an open non-stented dismembered pyeloplasty between 2003 and 2008 was performed. Duration of urinary leakage and postoperative complications were tabulated. Patients were considered to have a dry anastomosis if the Penrose drain was removed within one week of surgery.
Duration of leakage ranged from 0 to 27 days. 86% had Penrose drain removal within 7 days of surgery and were considered dry.14 patients demonstrated a persistent urinary leakage (PUL) ranging from 7 to 27 days. Complications of any type were significantly more likely in the group with prolonged drainage (p = .0126). UTI and obstruction were not significantly more likely to occur in patients with PUL (p = .0931 and p = .2616 respectively). Only one patient with PUL required placement of a ureteral stent.
We demonstrate that stentless dismembered pyeloplasty is feasible with a low rate of urinary drainage beyond one week. The character and quality of the slightly increased complications in those that demonstrated PUL were not great and not bothersome enough to warrant routine stenting.
我们旨在确定行开放、无支架离断式肾盂成形术治疗肾盂输尿管连接部梗阻的小儿患者术后尿漏的持续时间及相关并发症。
回顾性分析 2003 年至 2008 年间 100 例行开放无支架离断式肾盂成形术的患者。记录尿漏持续时间和术后并发症。如果术后一周内拔除引流管，则认为吻合口干燥。
漏尿持续时间 0-27 天。86%的患者术后 7 天内拔除引流管，认为是干燥的。14 例患者持续漏尿（PUL）7-27 天。有延长引流的患者发生任何类型并发症的可能性显著更高（p=0.0126）。PUL 患者发生尿路感染和梗阻的可能性并不更高（p=0.0931 和 p=0.2616 分别）。仅 1 例 PUL 患者需要留置输尿管支架。
我们证明无支架离断式肾盂成形术是可行的，术后一周以上引流的发生率较低。在出现 PUL 的患者中，并发症的性质和质量略有增加，但并不严重，也不会造成太大的困扰，不需要常规支架置入。
