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Titolo:
Endopyelotomy in the symptomatic older child
Autore:
Nicholls, G; Hrouda, D; Kellett, MJ; Duffy, PG;
Indirizzi:
Middlesex Hosp, Inst Urol, London, England Middlesex Hosp London England iddlesex Hosp, Inst Urol, London, England
Titolo Testata:
BJU INTERNATIONAL
fascicolo: 6, volume: 87, anno: 2001,
pagine: 525 - 527
SICI:
1464-4096(200104)87:6<525:EITSOC>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
URETEROPELVIC JUNCTION OBSTRUCTION;
Keywords:
endopyelotomy; crossing vessels; outcome; pelvi-ureteric junction;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
10
Recensione:
Indirizzi per estratti:
Indirizzo: Duffy, PG Great Ormond St Hosp Children, Dept Urol, Great Ormond St, London WC1N 3JH, England Great Ormond St Hosp Children Great Ormond St London England WC1N 3JH
Citazione:
G. Nicholls et al., "Endopyelotomy in the symptomatic older child", BJU INT, 87(6), 2001, pp. 525-527

Abstract

Objective To evaluate the results of endopyelotomy in children, an established method in adult practice as a treatment for pelvi-ureteric junction (PUJ) obstruction. Patients and methods Endopyelotomies undertaken between 1992 and 1999 by one surgeon in an established endourology unit were reviewed retrospectively. Children aged > 5 years presenting with pain and obstruction on isotope renography were selected for endopyelotomy. Patients with crossing vessels detectable on spiral computed tomography were treated by open pyeloplasty. Access to the renal pelvis was provided by a uroradiologist. Endopyelotomy was carried out through an Amplatz sheath of (median) 26 F. After applying traction to invaginate the PUJ an incision was made posterolaterally using electrocautery via an 11F paediatric resectoscope. Stenting was maintained for 6 weeks. In all, 13 patients (median age 10 years, range 5-14) were treated; two had associated calculi. Results The symptoms resolved and the obstruction was relieved in only sixpatients, with a median (range) follow-up of 50 (26-68) months. The seven patients in whom endopyelotomy failed, as indicated by persistent pain, proceeded to open pyeloplasty at a median (range) of 4 (1.3-79) months. Of these, two had presented with associated multiple calculi and significant hydronephrosis tone with an associated duplex system) and three had crossing lower pole vessels at open operation. One developed a urinoma after the original endopyelotomy and one had a retained stent fragment removed at the timeof pyeloplasty. Conclusions Endopyelotomy in the symptomatic child requires a careful preoperative evaluation. Crossing lower pole vessels warrant an open pyeloplasty.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/01/20 alle ore 15:29:31