Piyeloplasti Yapılan Ureteropelvik Bileşke Darlıklı Hastaların Epidemiyolojik Verileri: Tek Merkez Deneyimi

Year 2022, Volume: 7 Issue: 1, 112 - 116, 01.03.2022

Turan Yıldız Necmettin Akpınar Hasan Arık Ahmet Taner Elmas Sema Uğuralp

https://doi.org/10.26453/otjhs.1034224

Abstract

Amaç: Antenatal hidronefrozun bebeklerde sık nedeni geçici ve kalıcı üreteropelvik bileşke darlığı (UPD)’dır. Renal hasar oluşturan veya oluşturma potansiyeli olan tüm hastalara piyeloplasti uygulanır. Biz bu çalışmada piyeloplasti yaptığımız hastalarımızın epidemiyolojik verilerini paylaşmak istedik.
Materyal ve Metot: Çalışmamızda 2011-2021 yılları arasında UPD nedeni ile opere edilen 131 hastayı değerlendirdik. Hastaların tanı zamanı, operasyon yaşı, takip süresi, cinsiyet, patolojinin tarafı, başvuru şikâyetleri, patolojinin etiyolojisi ve karşı böbrek patolojisi kaydedildi.
Bulgular: Çalışmaya 109 hasta dâhil edildi. Hastaların %76,1’i erkek, %23,9’u kızdı. Erkek çocuklarda patoloji daha sıklıkla solda (%65,1) görülürken, kız çocuklarında patoloji daha sıklıkla sağda (%57,7) idi (p=0,036). Ortalama piyeloplasti yaşı 39,27±48,01 aydı. Antenatal tanılı hastaların ortalama piyeloplasti yaşı 15,74±23,48 aydı, geç dönem tanılı çocukların ortalama piyeloplasti yaşı 82,52±51,97 aydı (p=0,003). Aberan damar basılı UPD hastalarının %66,7’si geç dönemde tanı alırken, intrinsik nedenli hastaların %29,8’i geç dönemde tanı almıştı (p=0,005).
Sonuç: Üreteropelvik bileşke darlığı sıklıkla antenatal dönemde tanı almakta, erkek çocuklarında ve solda sık görülmektedir. Çalışmamızda kız çocuklarında sağ piyeloplastinin daha sık yapıldığı görülmüştür. Aberan damar basılı hastalar antenatal dönemde de tanı alabilmektedir. Bununla birlikte ilerleyen yaşlarda başvuran hastalarda aberan basılı UPD daha sık görülmektedir. 

Keywords

Çocuk, epidemiyoloji, piyeloplasti, üreteropelvik bileşke darlığı

Supporting Institution

yok

Project Number

2021/1673

Epidemiological Data of Patients with Ureteropelvic Junction Stenosis Performed Pyeloplasty: A Single Center Experience

Abstract

Objective: The common cause of antenatal hydronephrosis in infants is temporary and permanent ureteropelvic junction stenosis (UPJS). Pyeloplasty is applied to all patients who have or have the potential to cause renal damage. This study, it was aimed to share the epidemiological data of our patients who underwent pyeloplasty.
Materials and Methods: In our study, we evaluated 131 patients who were operated for UPJS between 2011 and 2021. The time of diagnosis, age of operation, duration of follow-up, gender, side of the pathology, complaints on admission, etiology of the pathology and contralateral kidney pathology were recorded.
Results: 109 patients were included in the study. 76.1% of the patients were male and 23.9% were female. While pathology was more common on the left (65.1%) in boys, pathology was more common on the right (57.7%) in girls (p=0.036). The mean age of pyeloplasty was 39.27±48.01 months. The mean age of pyeloplasty in patients with antenatal diagnosis was 15.74±23.48 months, and the mean age of pyeloplasty in children with late diagnosis was 82.52±51.97 months (p=0.003). While 66.7% of UPD patients with aberrant vein pressure were diagnosed in the late period, 29.8% of the patients with intrinsic causes were diagnosed in the late period (p=0.005).
Conclusion: Ureteropelvic junction stenosis is frequently diagnosed in the antenatal period and is common in boys and on the left. In our study, it was observed that right pyeloplasty was performed more frequently in girls. Patients with aberrant vascular pressure can also be diagnosed in the antenatal period. However, UPJS with aberrant vascular pressure is seen more frequently in patients admitted at older ages.

Keywords

Child, epidemyology, pyeloplasty, ureteropelvic junction stenosis

Project Number

2021/1673

References

• Yalçınkaya F, Özçakar ZB. Management of antenatal hydronephrosis. Pediatr Nephrol. 2020;35(12):2231-2239. doi:10.1007/s00467-019-04420-6
• Värelä S, Omling E, Börjesson A, Salö M. Resolution of hydronephrosis after pyeloplasty in children. J Pediatr Urol. 2021;17(1):102.e1-102.e7. doi:10.1016/j.jpurol.2020.10.031
• Li B, McGrath M, Farrokhyar F, Braga LH. Ultrasound-based scoring system for indication of pyeloplasty in patients with UPJO-like hydronephrosis. Front Pediatr. 2020;8:353. doi:10.3389/fped.2020.00353
• Olsen LH, Rawashdeh FH. Surgery of the ureter in children: Ureteropelvic junction, megaureter, and vesicoureteral reflux. In: Partin AW, Wein AJ, Kavoussi LR, Peters CA, Dmochowski RR, ed. Campell Walsh Wein Urology. 12 th edition. Philadelphia, Elseiver, Inc; 2020:826-852.
• Kohno M, Ogawa T, Kojima Y, ve ark. Pediatric congenital hydronephrosis (ureteropelvic junction obstruction): Medical management guide. Int J Urol. 2020;27(5):369-376. doi:10.1111/iju.14207
• Ceyhan E, Ileri F, Ceylan T, Aydin AM, Dogan HS, Tekgul S. Predictors of recurrence and complications in pediatric pyeloplasty. Urology. 2019;126:187-191. doi:10.1016/j.urology.2019.01.014
• Bilge I. Symptomatology and clinic of hydronephrosis associated with uretero pelvic junction anomalies. Front Pediatr. 2020;8:520. doi:10.3389/fped.2020.00520
• Has R, Sarac Sivrikoz T. Prenatal diagnosis and findings in ureteropelvic junction type hydronephrosis. Front Pediatr. 2020;8:492. doi:10.3389/fped.2020.00492
• Miscia ME, Lauriti G, Riccio A, ve ark. Minimally invasive vascular hitch to treat pediatric extrinsic ureteropelvic junction obstruction by crossing polar vessels: A systematic review and meta-analysis. J Pediatr Urol. 2021;17(4):493-501. doi:10.1016/j.jpurol.2021.03.002
• Esposito C, Bleve C, Escolino M, ve ark. Laparoscopic transposition of lower pole crossing vessels (vascular hitch) in children with pelviureteric junction obstruction. Transl Pediatr. 2016;5(4):256-261. doi:10.21037/tp.2016.09.08
• Carpenter CP, Tolley E, Tourville E, Sharadin C, Giel DW, Gleason JM. Hydronephrosis after pyeloplasty: "Will it go away?". Urology. 2018;121:158-163. doi:10.1016/j.urology.2018.08.010
• Weiss DA, Kadakia S, Kurzweil R, Srinivasan AK, Darge K, Shukla AR. Detection of crossing vessels in pediatric ureteropelvic junction obstruction: Clinical patterns and imaging findings. J Pediatr Urol. 2015;11(4):173.e1-5. doi:10.1016/j.jpurol.2015.04.017
• Cain MP, Rink RC, Thomas AC, Austin PF, Kaefer M, Casale AJ. Symptomatic ureter opelvic junction obstruction in children in the era of prenatal sonography-is there a higher incidence of crossing vessels? Urology. 2001;57:338–341.
• Rooks VJ, Lebowitz RL. Extrinsic ureteropelvic junction obstruction from a crossing renal vessel: demography and imaging. Pediatr Radiol. 2001;31:120–124.
• Hegde S, Menon P, Rao KLN. Co-Existing pediatric ureteropelvic junction obstruction and vesicoureteric reflux: Prevalence and implications. J Indian Assoc Pediatr Surg. 2019;24(2):109-116. doi:10.4103/jiaps.JIAPS_37_18