Shi Tong, Lao Weihua, Ouyang Keyu, Chen Yueqing, Zhang Yikui, Luo Jiayao, Chen Shuhan
Pediatric Urology, Guangdong Women and Children Hospital, Guangzhou, China.
Front Pediatr. 2024 Mar 14;12:1343211. doi: 10.3389/fped.2024.1343211. eCollection 2024.
We aimed to investigate the short-term efficacy and safety of laparoscopic pyeloplasty for treating newborns with severe hydronephrosis due to ureteropelvic junction obstruction (UPJO).
A retrospective analysis was performed on 16 newborn patients with severe neonatal hydronephrosis who underwent laparoscopic pyeloplasty at our hospital from January 2021 to November 2022. All patients were regularly followed up. Laparoscopic pyeloplasty with double J stent placement was performed after the presence of severe hydronephrosis was confirmed.
Among the 16 pediatric patients (13 males, 3 females), the left side was affected in 13 cases and the right side in 3. The average age at surgery was 9.50 (8.50-12.00) days, with an average weight of 3.30 ± 0.95 kg. Laparoscopic pyeloplasty was performed in all cases without the need for open conversion. The mean surgery duration was 292.06 ± 73.60 min, with minimal blood loss (2.50, 2.00-5.00 ml). Postoperative hospital stays averaged 13.44 ± 4.70 days. No anastomotic leakage occurred, and follow-ups at 1, 3, 6, and 12 months showed no stent displacement, except for one case where the stent was removed at 1 month, and the others at 3 months. There were no cases of worsened hydronephrosis, except for one with renal atrophy at the 6-month follow-up. Changes in renal pelvis anteroposterior diameter exhibited a time effect ( = 49.281, < 0.001), with significant differences at 1, 3, 6, and 12 months postoperatively compared to preoperative values (< 0.05). Notably, differences were observed between 6 and 3 months, as well as between 12 and 3 months postoperatively (< 0.05). Similarly, renal parenchymal thickness changes showed a time effect Pediatric urology, Guangdong Women and Children Hospital, Guangzhou, China ( = 49.281, < 0.001), with significant differences at 1, 3, 6, and 12 months postoperatively compared to preoperative values (< 0.05). Significant differences were also noted between 6 and 1 month, as well as between 12 and 1 month postoperatively (< 0.05). There was one case of urinary tract infection after surgery, and no case of recurrence was observed.
Severe neonatal hydronephrosis must be treated promptly. Laparoscopic pyeloplasty is a safe and feasible treatment with minimal complications for newborn patients with severe hydronephrosis due to UPJO.
我们旨在研究腹腔镜肾盂成形术治疗因输尿管肾盂连接部梗阻（UPJO）导致严重肾积水的新生儿的短期疗效和安全性。
对2021年1月至2022年11月在我院接受腹腔镜肾盂成形术的16例严重新生儿肾积水患者进行回顾性分析。所有患者均定期随访。在确诊存在严重肾积水后，进行带双J管置入的腹腔镜肾盂成形术。
16例患儿（男13例，女3例）中，左侧受累13例，右侧3例。手术平均年龄为9.50（8.50 - 12.00）天，平均体重为3.30±0.95 kg。所有病例均成功进行了腹腔镜肾盂成形术，无需转为开放手术。平均手术时间为292.06±73.60 min，术中出血极少（2.50，2.00 - 5.00 ml）。术后平均住院时间为13.44±4.70天。无吻合口漏发生，在1、3、6和12个月的随访中，除1例在1个月时取出支架，其他在3个月时取出支架外，无支架移位情况。除1例在6个月随访时出现肾萎缩外，无肾积水加重病例。肾盂前后径变化呈现时间效应（=49.281，<0.001），术后1、3、6和12个月与术前值相比有显著差异（<0.05）。值得注意的是，术后6个月与3个月之间以及12个月与3个月之间存在差异（<0.05）。同样，肾实质厚度变化也呈现时间效应（=49.281，<0.001），术后1、3、6和12个月与术前值相比有显著差异（<0.05）。术后1个月与6个月之间以及12个月与1个月之间也有显著差异（<0.05）。术后有1例发生尿路感染，无复发病例。
严重新生儿肾积水必须及时治疗。腹腔镜肾盂成形术对于因UPJO导致严重肾积水的新生儿患者是一种安全可行、并发症极少的治疗方法。
Zotero 插件
