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Surgical Treatment and Efficacy Observation of Hydronephrosis in Children

Author: TaoWeiXiong
Tutor: ZengFuQing
School: Huazhong University of Science and Technology
Course: Surgery
Keywords: Children Hydronephrosis Surgical treatment Effect
CLC: R726.9
Type: Master's thesis
Year: 2010
Downloads: 25
Quote: 0
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Abstract


Background and objective of researchHydronephrosis in children is the most common congenital abnormality of the uropathy. Ureteropelvic junction obstruction, ureterovesical junction stenosis and vesicoureteral reflux are implicated in the majority of cases of hydronephrosis in children. Whether and when the postnatal hydronephrosis need to surgical intervention is still on the controversy. Nowadays the necessity and effect in the surgical intervention is still one of the focus in the research of the hydronephrosis. More than 50 cases of hydronephrosis in children were examinated and accepted surgical intervention since the melamine milk powder incident occurred in 2008. We analyzed and discussed the 52 cases of hydronephrosis and followed the patients and aimed to summarize the clinical treatment experience of pediatric hydronephrosis and evaluated the effect of postoperation.Clinic data and methodsThe clinical data of 52 cases of hydronephrosis in children were analyzed retrospectively. 36 cases were treated by Anderson-Hynes pyeloplasty(4 cases were bilateral hydronephrosis), 12 cases by ureteric reimplantation, 3 cases by nephroureterectomy and 1 cases were treated by ureteric polyp resect and an end-to-end anastomosis of the ureter were performed. Among the cases underwent dismembered pyeloplasty, 10 cases were placed external drainage fistula through the anastomotic mouth, and 30 cases were placed double J tube internal drainage. The stenosis of UPJ were sent to pathological examination. Ultrasound and ECT were reviewed periodically after operation.Results48 cases were cured in the first surgery, and one was cured after a second surgery, and 3 cases lost kidney. The complications in the group placed double J tube significantly lower than the group placed external drainage fistula (3.3% VS 40%,P<0.01). Symptoms were disappeared and the degree of hydronephrosis was alleviated obviously through ultrasound examination. The mean preoperative and postoperative renal function of 26 cases was(23.58±9.28)ml/min and (33.25±10.63)ml/min respectively (p<0.01).Conclusions1、Double J tube internal drainage should be the best choice in the Anderson-Hynes pyeloplasty.2、Hydronephrosis in children must be early treated by surgery. To resect obstruction or resist vesico-ureteric reflux can recover renal function greatly.

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CLC: > Medicine, health > Pediatrics > Pediatric surgery > Pediatric urology science
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