Wang Tianyi,Zhang Yu,Fu Mingcui,et al.Massive urinary extravasation after pyeloplasty in children:clinical features and prognoses[J].Journal of Clinical Pediatric Surgery,,():323-327.[doi:10.3760/cma.j.cn101785-202403060-005]
Massive urinary extravasation after pyeloplasty in children:clinical features and prognoses
- Keywords:
- Ureteropelvic Junction Obstruction; Laparoscopy; Pyeloplasty; Postoperative Complications; Urinary Extravasation; Child
- Abstract:
- Objective To explore the clinical features and outcomes of massive urinary extravasation after pyeloplasty in children. Methods From January 2016 to December 2023,the relevant clinical data were retrospectively reviewed for 18 children with massive urinary extravasation after pyeloplasty.Demographic profiles,medical history,perioperative images,urinary extravasation during hospitalization,and treatment outcomes were recorded. Results There were 16 boys and 2 girls with an operative age of (6.03±4.79) year.Obstruction was located at left (n=16) and right (n=2).Length of hospitalization stay was 20 (13-24) day and median duration of massive postoperative urinary extravasation 2(1-20) day.In 17/18 children,abdominal drainage tube was retained for a median duration of 11(8-15) day.The highest volume of abdominal drainage fluid withinin a single day was 485(298-786) ml.Clavien-Dindo grade of postoperative complications was Ⅰ (n=8),Ⅱ (n=4) and Ⅲb (n=6).The frequency of reoperation during hospitalization was 33.33%(6/18).The perioperative APD were (4.11±1.83) and 2.40(1.58,4.53) cm with statistically significant difference (Z=-2.628,P=0.009).Perioperative PTmin was 0.6(0.2,0.8) and (0.93±0.32) cm with statistically significant difference (Z=-2.580,P=0.011).Perioperative ratio of APD/PT was 6.05(2.85-13.44) and 2.64(1.95-5.73) with statistically significant difference (Z=-2.940,P=0.002).Postoperative values of APD,PTmin,and APD/PT significantly improved as compared preoperatively.PI-APD was 20.95%(-0.45%,60.91%).There were two cases of postoperative re-obstruction.Overall success rate of operation was 88.89%(16/18). Conclusions Severe urinary extravasation after pyeloplasty may result in an extended duration of hospitalization and an elevated probability of reoperation.However,the occurrence of re-obstruction after pyeloplasty with massive urine extravasation remains low.
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Memo
收稿日期:2024-01-02。
基金项目:江苏省高等学校自然科学研究项目(23KJD320003); 苏州市科技发展计划项目(SKY2023002); 苏州市儿童结构畸形重点实验室建设项目(SZS2022018); 青海省卫生健康委员会科研项目(2023—wjzdx—44); 苏州市科技发展计划(医疗卫生科技创新)项目(SKY2022053)
通讯作者:付明翠,Email:fumc2005@163.com