He Yan, Wu Xuemin, Xu Yingrui, Liu Zhaoquan, Du Guoqiang, Wu Xiangyu, Liu Wei, Wu Rongde
Department of Pediatric Surgery, Shandong Provincial Hospital, Shandong University, Jinan, China.
Department of Pediatric Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
Front Pediatr. 2023 Jun 23;11:1164474. doi: 10.3389/fped.2023.1164474. eCollection 2023.
To observe the postoperative recovery following ureteral dilation in primary obstructive megaureter (POM) after ureteral implantation, and evaluate the risk factors affecting ureter diameter resolution.
A retrospective study was performed in patients with POM who underwent ureteral reimplantation using the Cohen procedure. Patient characteristics, perioperative parameters, and postoperative outcomes were also analysed. A widest ureteral diameter of <7 mm was defined as a normal shape and outcome. Survival time was defined as the time from surgery to ureteral dilation recovery or to the last follow-up.
A total of 49 patients (54 ureters) were included in the analysis. The survival time ranged from 1 to 53 months. The shapes of a total of 47 (87.04%) megaureters recovered, and most (29/47) resolutions happened within 6 months after surgery. In the univariate analysis, bilateral ureterovesical reimplantation (= 0.015), ureteral terminal tapering (= 0.019), weight (= 0.036), and age (= 0.015) were associated with the recovery time of ureteral dilation. A delayed recovery of ureteral diameter was noted in bilateral reimplantation (HR = 0.336, = 0.017) using multivariate Cox regression.
Ureteral dilation in POM mostly returned to normal within six postoperative months. Moreover, bilateral ureterovesical reimplantation is a risk factor for delayed postoperative recovery of ureter dilation in POM.
观察原发性梗阻性巨输尿管（POM）输尿管植入术后输尿管扩张的恢复情况，并评估影响输尿管直径恢复的危险因素。
对采用科恩手术进行输尿管再植的POM患者进行回顾性研究。分析患者特征、围手术期参数和术后结果。将最宽输尿管直径<7 mm定义为正常形态和结果。生存时间定义为从手术到输尿管扩张恢复或最后一次随访的时间。
共纳入49例患者（54条输尿管）进行分析。生存时间为1至53个月。共有47条（87.04%）巨输尿管形态恢复，大多数（29/47）在术后6个月内恢复。单因素分析中，双侧输尿管膀胱再植（P = 0.015）、输尿管末端变细（P = 0.019）、体重（P = 0.036）和年龄（P = 0.015）与输尿管扩张的恢复时间相关。多因素Cox回归分析显示，双侧再植时输尿管直径恢复延迟（HR = 0.336，P = 0.017）。
POM患者输尿管扩张大多在术后6个月内恢复正常。此外，双侧输尿管膀胱再植是POM患者输尿管扩张术后恢复延迟的危险因素。
