Wang Yusi,Ren Zhentao,Zhang Weiping,et al.Clinical diagnosis and treatment of hydronephrosis caused by ureteral fibroepithelial polyp in children[J].Journal of Clinical Pediatric Surgery,,20():1026-1030.[doi:10.12260/lcxewkzz.2021.11.006]
Clinical diagnosis and treatment of hydronephrosis caused by ureteral fibroepithelial polyp in children
- CLC:
- R726.92;R693
- Abstract:
- Objective To explore the clinical features of children with ureteral fibroepithelial polyp (UFP) causing hydronephrosis and boost its levels of diagnosis and treatment. Methods From September 2006 to September 2019, general profiles, clinical manifestations, imaging examinations, surgical approaches and follow-ups were retrospectively reviewed for 48 children with a postoperative pathological diagnosis of UFP. Results They accounted for 1.8%(48/2653) of patients with hydronephrosis during the same period. The mean age was (109.2±34.7) months. Boys predominated (95.8%) and occurred unilaterally in left ureter (81.3%). The major symptoms were flank pain (81.3%) and hematuria (18.8%). The positive rate of ultrasonography was 60.4% and intravenous pyelography merely 34.1%. All polyps were completely resected. The lesions were mostly located in proximal ureter (97.9%) with single predominance (70.8%). The median length of polyps were 1.5 (0.3-8.0) cm. The mean follow-up period was 57(3-141) months. Postoperative complications occurred in 3 children (6.3%), including long-term complications (n=2). Conclusion Ureteral fibroepithelial polyps are rare and yet have typical clinical features. Ultrasonography is a noninvasive and effective tool of detecting UFP in children. Resection efficacy is definite with a low recurrence rate. However, clinicians should prolong the postoperative follow-up period to prevent long-term complications.
References:
1 Adey GS, Vargas SO, Retik AB, et al. Fibroepithelial polyps causing ureteropelvic junction obstruction in children[J].J Urol, 2003, 169(5):1834-1836.DOI:10.1097/01.ju.0000061966.21966.94.
2 Williams TR, Wagner BJ, Corse WR, et al. Fibroepithelial polyps of the urinary tract[J].Abdom Imaging, 2002, 27(2):217-221.DOI:10.1007/s00261-001-0066-z.
3 Kara C, Re?orlu B, O?uz U, et al. Incidentally detected ureteral fibroepithelial polyps in children:is endoscopic treatment of them really necessary?[J].Int Uroland Nephrol, 2010, 42(1):1-5.DOI:10.1007/s11255-009-9567-4.
4 Wang XM, Jia LQ, Wang Y, et al. Utilizing ultrasonography in the diagnosis of pediatric fibroepithelial polyps causing ureteropelvic junction obstruction[J].Pediatr Radiol, 2012, 42(9):1107-1111.DOI:10.1007/s00247-012-2404-4.
5 Li R, Lightfoot M, Alsyouf M, et al. Diagnosis and management of ureteral fibroepithelial polyps in children:A new treatment algorithm[J].J Pediatr Urol, 2015, 11(1):21-22.DOI:10.1016/j.jpurol.2014.08.004.
6 王盛兴, 陈琳, 葛文安, 等. 16例儿童原发性输尿管息肉致肾积水的临床特点及诊治体会[J].山东医药, 2015, 55(41):85-86.DOI:10.3969/j.issn.1002-266X.2015.41.035. Wang LX, Chen L, Ge WA, et al. Clinical characteristics and managements of hydronephrosis caused by ureteral polyp in 16 children[J].Shandong Med J, 2015, 55(41):85-86.DOI:10.3969/j.issn.1002-266X.2015.41.035.
7 Niu ZB, Yang Y, Hou Y, et al. Ureteral polyps:an etiological factor of hydronephrosis in children that should not be ignored[J].Pediatr Surg Int, 2007, 23(4):323-326.DOI:10.1007/s00383-007-1884-z.
8 Dai LN, Chen CD, Lin XK, et al. Retroperitoneal laparoscopy management for ureteral fibroepithelial polyps causing hydronephrosis in children:A report of five cases[J].J Pediatr Urol, 2015, 11(5):251-257.DOI:10.1016/j.jpurol.2015.02.019.
9 Kojima Y, Lambert SM, Steixner BL, et al. Multiple metachronous fibroepithelial polyps in children[J].J Urol, 2011, 185(3):1053-1057.DOI:10.1016/j.juro.2010.10.046.
10 Bian ZD, Liu X, Hua Y, et al. Laparoscopic management of multiple ureteral polyps in children[J].J Urol, 2011, 186(4):1444-1449.DOI:10.1016/j.juro.2011.05.056.
11 Romesburg JW, Stein RJ, Desai MM, et al. Treatment of child with bilateral ureteropelvic junction obstruction due to fibroepithelial polyps and review of the literature[J].Urology, 2009, 73(4):929.e9-e11.DOI:10.1016/j.urology.2008.04.040.
12 Ludwig DJ, Buddingh KT, Kums JJ, et al. Treatment and outcome of fibroepithelial ureteral polyps:A systematic literature review[J].Can Urol Assoc J, 2015, 9(9-10):E631-E637.DOI:10.5489/Cuaj.2878.
13 马睿.儿童肾积水的影像学诊断策略[J].临床小儿外科杂志, 2020, 19(3):199-202.DOI:10.3969/j.issn.1671-6353.2020.03.002. Ma R.Imaging-based diagnostic strategies of pediatric hydronephrosis[J].J Clin Ped Sur, 2020, 19(3):199-202.DOI:10.3969/j.issn.1671-6353.2020.03.002.
14 Radojicic Z, Basta-Jovanovic G, Dimitrijevic I, et al. Fibroepithelial polyp of the upper third of ureter[J].ANZ J Surg, 2008, 78(8):718.DOI:10.1111/j.1445-2197.2008.04630.x.
15 Childs MA, Umbreit EC, Krambeck AE, et al. Fibroepithelial polyps of the ureter:a single-institutional experience[J].J Endourol, 2009, 23(9):1415-1419.DOI:10.1089/end.2009.0403.
16 Ruíz-López MJ, Ramírez-Garrido F, Nogueras-Oca?a M, et al. Recurrent ureteric fibroepithelial polyp in a child[J].Euro J Pediatri, 2004, 163(2):124-125.DOI:10.1007/s00431-002-1052-3.
Memo
收稿日期:2020-12-06。
基金项目:北京市医院管理局儿科协同发展专项子课题（编号：XTZD20180303）
通讯作者:张潍平,Email:zhangwp59616406@126.com