[Surgical treatment for ureteropelvic junction syndrome in infants and children (report of 73 cases)].
between 1982 and 1990, 73 children were operated for pyeloureteric junction syndrome (76 pyeloplasties). The authors distinguish between a group of 45 infants operated before the age of 2 years and a group of 35 children operated after the age of 2 years. 40% of these cases had been detected antenatally, which modified the management and treatment of these infants, operated at about the age of 6 months (mean: 6.6 months). Treatment was conservative (one nephrectomy out of the 41 infants operated: 2.4%). Pyeloplasty was performed according to the Anderson-Hynes-Küss resection-anastomosis technique under an operating magnifying glass. Early surgery offers the best chance of recovery. Urinary tract drainage was not systematic in these infants (50% of cases) and did not affect the long term results. Early complications and surgical revisions (3.9%) were not more frequent in the infants operated earlier. The definitive results were good in 88.5% of cases, while 7.2% of cases required further surveillance. Renal parenchymal lesions (4.3%) were related more to pyelonephritis than to failure of surgery. Overall, a conservative surgical approach is recommended, except in minor syndromes which require rigorous surveillance.
Michel
A
A
Service d'Urologie, C.H.U. de Grenoble.
Monod
P
P
Descotes
J L
JL
Rambeaud
J J
JJ
Bourdat
G
G
Faure
G
G
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols / Q000592:standards; D003558:Cystoscopy; D003663:Decision Trees; D004106:Dilatation / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007682:Kidney Pelvis; D008297:Male; D009392:Nephrectomy / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D012720:Severity of Illness Index; D012737:Sex Factors; D013577:Syndrome; D016216:Ultrasonography, Prenatal; D014517:Ureteral Obstruction / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D014567:Urography
Le traitement chirurgical du syndrome de la jonction pyélo-urétérale chez le nourrisson et l'enfant (à propos de 73 observations).