Wolpert J J, Woodard J R, Parrott T S
Urology Service, Henrietta Egleston Hospital for Children, Atlanta, Georgia.
J Urol. 1989 Aug;142(2 Pt 2):573-5; discussion 603-5. doi: 10.1016/s0022-5347(17)38820-1.
The urgency, safety and benefits of performing pyeloplasty during the first weeks of life currently are being questioned. We reviewed our experience with 114 pyeloplasties in 103 infants and young children performed between 1983 and 1987. The 34 patients who underwent an operation before they were 3 months old were compared to 69 operated upon after 3 months. The surgical results in the 2 groups were equally good, with 90 per cent of the cases having an improved or stable postoperative excretory urogram or renal scan. Complications were few and were more common in the older age group, in which 7 children required a secondary procedure, including 2 for recurrent obstruction at the ureteropelvic junction. No patient in the younger age group required a secondary procedure for treatment of a complication or recurrent obstruction. Our findings indicate that the success of pyeloplasty performed during the first weeks of life is equal to that performed at a later patient age and were not more likely to be followed by a complication.
目前，在出生后的头几周内进行肾盂成形术的紧迫性、安全性和益处正受到质疑。我们回顾了1983年至1987年间对103例婴幼儿进行的114例肾盂成形术的经验。将34例在3个月前接受手术的患者与69例在3个月后接受手术的患者进行了比较。两组的手术结果同样良好，90%的病例术后排泄性尿路造影或肾扫描结果有所改善或稳定。并发症很少见，且在年龄较大的组中更常见，其中7名儿童需要二次手术，包括2例因输尿管肾盂连接处反复梗阻而进行的手术。较年轻年龄组中没有患者因并发症或反复梗阻而需要二次手术治疗。我们的研究结果表明，在出生后的头几周内进行肾盂成形术的成功率与在患者年龄较大时进行的手术相同，并且发生并发症的可能性并不更高。
