Pyeloplasti Sonrası Böbrek Fonksiyonlarında Düzelme Olur mu? Düşük Renal Fonksiyonlu 13 Olgunun Değerlendirilmesi

Öz

Amaç: Üreteroplevik bileşke obstrüksiyonlu çocuk olgularda pyeloplasti sonrası fonksiyonel düzelme özellikle düşük fonksiyonlu böbreklerde halen tartışmalıdır. Literatürde opere edilen düşük renal fonksiyonlu olgularda iyileşme üzerine görüş birliği yoktur. Çalışmamızda düşük renal fonksiyonlu olgularda pyeloplasti sonrası iyileşme olup olmadığı amaçlandı.Gereç ve Yöntemler: Ocak 2009-Aralık 2015 tarihleri arasında opere edilen 80 olgudan 13 düşük fonksiyonlu olgunun preoperatif ve postoperatif diferansiye fonksiyonları, böbrek ön arka çapı ve parankimal kalınlığı değerlendirildi. Preoperatif ve postoperatif bulguların karşılaştırılması ile iyileşme olup olmadığına karar verildi.Bulgular: Diferansiye böbrek fonksiyonu %30’un altında olan 13 olgu değerlendirildi. 5 olgu antenatal hidronefrozi nedeni ile tanı alırken, 4 olgu üriner sistem enfeksiyonu sonrası, 4 olgu ise karın ağrısı semptomu ile tanı aldı. 13 olgudan 3’ünde postoperatif dönemde böbrek fonksiyonlarında %5’den fazla düzelme saptandı. Serimizde ameliyat öncesi ve sonrası böbrek fonksiyonları karşılaştırıldığında istatistiksel olarak anlamlı fark bulunmadı.Sonuç: Serimizdeki düşük fonksiyonlu UPJO nedeni ile pyeloplasti yapılan olgularda ameliyat sonrası bir değişiklik izlenmemiştir. Özellikle konservatif olarak izlenen hastalarda fonksiyon kaybı olmadan pyeloplasti yapılması önemlidir.

Anahtar Kelimeler

• Üreteropelvik bileşke tıkanıklığı, Düşük renal fonksiyon, Pyeloplasti

Is Differential Renal Function Improved After Pyeloplasty? Evaluation of 13 Cases with Low Differential Renal Function

Öz

Objective: Functional improvement after pyeloplasty in pediatric ureteropelvic junction obstruction (UPJO) is still debated, especially in poorly functioning kidneys. There is no consensus about the improvement of cases operated with poor renal function in the literature. In our study, we aimed to investigate whether there was an improvement after pyeloplasty in poor functioning cases. Material and Methods: Thirteen of the 80 cases operated between January 2009 - December 2015 with poor renal function were evaluated in terms of preoperative and postoperative differential functions, renal antero-posterior diameter and parenchymal thickness. We determined whether improvement was present by comparing preoperative and postoperative findings.Results: A total of 13 cases with differential renal function (DRF) less than 30% evaluated. Five of the cases were diagnosed after antenatal hydronephrosis, 4 after urinary tract infection and 4 following abdominal pain symptoms. Renal function improvement more than 5% was found in 3 of the 13 cases postoperatively. There was no statistically significant difference between preoperative to postoperative improvement of differential renal function in these series.Conclusion: There was no change in postoperative renal function in cases with low functional UPJO after pyeloplasty in our series. It is important to perform pyeloplasty before significant loss of function during the follow-up, especially in patients who are monitored conservatively

Anahtar Kelimeler

• Ureteropelvic junction obstruction, Poor renal function, Pyeloplasty

Kaynakça

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