| ORIGINAL ARTICLE
|Year : 2022 | Volume
| Issue : 1 | Page : 25-31
Outcome analysis of reduction and nonreduction dismembered pyeloplasty in ureteropelvic junction obstruction: A randomized, prospective, comparative study
Enono Yhoshu1, Prema Menon1, Katragadda Lakshmi1, Narasimha Rao1, Anish Bhattacharya2
1 Department of Pediatric Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Objectives: The objective of this study is to compare the changes in renal function and drainage following open dismembered pyeloplasty with and without renal pelvis reduction.
Materials and Methods: Randomized prospective study of children with ureteropelvic junction obstruction undergoing pyeloplasty with (Group 1) and without (Group 2) pelvis reduction over an 18-month period. Postoperative function and drainage were assessed by ethylene dicysteine (EC) scan and intravenous urography (IVU) and renal pelvis size by ultrasonography.
Results: Forty-two patients (2 months-11 years) participated. The mean preoperative EC scan function was Group 1: 45.88% ± 14.42% (5%–80%) and Group 2: 39.22% ± 9.75% (21%–53%). (P = 0.117). The mean postoperative EC scan function of Group 1 was 42.64% ± 9.62% (17%–54%) and 43.75% ± 9.88% (17%–58%) and of Group 2 was 44.77% ± 12.82% (20%–68%) and 42.25% ± 8.56% (23%–58%) at 3 months (P = 0.584) and ≥ 1year (P = 0.385), respectively, with no significant difference. None required re-do pyeloplasty. The number of patients with slow drainage, especially at 3 months and also at ≥1-year postoperative period on EC scan was slightly higher in Group 2 compared to Group 1 but did not attain statistical significance. There was postoperative improvement in function and drainage on IVU with no significant difference between the two groups, (P = 0.214; P = 0.99, respectively). At a mean follow-up of 45.5 months, Group 2 also showed significant reduction in pelvis size on ultrasound (P = 0.011).
Conclusion: Postoperative function remained stable in both groups. More number of patients achieved unobstructed drainage by 3 mo postoperative after reduction pyeloplasty but drainage patterns were mostly similar between reduction and nonreduction of pelvis group in late follow-up.
Dr. Prema Menon
Room No. 3103, Level 3-A, Department of Pediatric Surgery, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012
Source of Support: None, Conflict of Interest: None
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