Frontiers in pediatrics · 2023
Ureteral dilation recovery after intravesical reimplantation in children with primary obstructive megaureter.
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He Yan, Wu Xuemin, Xu Yingrui, Liu Zhaoquan, Du Guoqiang, Wu Xiangyu, Liu Wei, Wu Rongde
Аннотация
BACKGROUND: To observe the postoperative recovery following ureteral dilation in primary obstructive megaureter (POM) after ureteral implantation, and evaluate the risk factors affecting ureter diameter resolution.
MATERIALS AND METHODS: A retrospective study was performed in patients with POM who underwent ureteral reimplantation using the Cohen procedure. Patient characteristics, perioperative parameters, and postoperative outcomes were also analysed. A widest ureteral diameter of <7 mm was defined as a normal shape and outcome. Survival time was defined as the time from surgery to ureteral dilation recovery or to the last follow-up.
RESULTS: A total of 49 patients (54 ureters) were included in the analysis. The survival time ranged from 1 to 53 months. The shapes of a total of 47 (87.04%) megaureters recovered, and most (29/47) resolutions happened within 6 months after surgery. In the univariate analysis, bilateral ureterovesical reimplantation (p = 0.015), ureteral terminal tapering (p = 0.019), weight (p = 0.036), and age (p = 0.015) were associated with the recovery time of ureteral dilation. A delayed recovery of ureteral diameter was noted in bilateral reimplantation (HR = 0.336, p = 0.017) using multivariate Cox regression.
CONCLUSIONS: Ureteral dilation in POM mostly returned to normal within six postoperative months. Moreover, bilateral ureterovesical reimplantation is a risk factor for delayed postoperative recovery of ureter dilation in POM.
MATERIALS AND METHODS: A retrospective study was performed in patients with POM who underwent ureteral reimplantation using the Cohen procedure. Patient characteristics, perioperative parameters, and postoperative outcomes were also analysed. A widest ureteral diameter of <7 mm was defined as a normal shape and outcome. Survival time was defined as the time from surgery to ureteral dilation recovery or to the last follow-up.
RESULTS: A total of 49 patients (54 ureters) were included in the analysis. The survival time ranged from 1 to 53 months. The shapes of a total of 47 (87.04%) megaureters recovered, and most (29/47) resolutions happened within 6 months after surgery. In the univariate analysis, bilateral ureterovesical reimplantation (p = 0.015), ureteral terminal tapering (p = 0.019), weight (p = 0.036), and age (p = 0.015) were associated with the recovery time of ureteral dilation. A delayed recovery of ureteral diameter was noted in bilateral reimplantation (HR = 0.336, p = 0.017) using multivariate Cox regression.
CONCLUSIONS: Ureteral dilation in POM mostly returned to normal within six postoperative months. Moreover, bilateral ureterovesical reimplantation is a risk factor for delayed postoperative recovery of ureter dilation in POM.