title: The risk factors and clinical significance of acute postoperative complications after unstented pediatric pyeloplasty: a single surgeon's experience.
abstract: OBJECTIVE
  To analyze the risk factors and clinical significance of postoperative complications after unstented pediatric pyeloplasty.
  
  
  METHODS
  We analyzed 285 kidney units (KUs) on which unstented pyeloplasty was performed between April 2002 and March 2010. Measures included preoperative factors, postoperative complications, change in postoperative differential renal function (DRF), and failure of pyeloplasty. Risk factors for acute complications requiring additional ureteral stenting and decreased DRF were analyzed.
  
  
  RESULTS
  During a median follow-up period of 67.0 months, an additional ureteral stenting was required in 28 KUs (9.8%) due to the development of acute postoperative complications after unstented pyeloplasty. The incidence of complications increased significantly as preoperative DRF increased. DRF of more than 60% was the only independent risk factor for acute complications. Postoperative decrease in DRF was observed in 58 KUs (22.4%) among 259 KUs analyzed. Pyeloplasty failure was observed in 10 KUs (3.5%). The development of acute complications was not a risk factor for a decrease in DRF or pyeloplasty failure.
  
  
  CONCLUSIONS
  Urinary diversion during pyeloplasty is not related to a decrease in DRF or pyeloplasty failure. However, in patients with a preoperative DRF of greater than 60%, diversion could be considered due to the high prevalence of complications.
authors: Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: asforthelord@yuhs.ac.
authors: Yong Seung
authors: YS
authors: Lee
authors: Department of Pediatric Urology, Severance Children's Hospital, Seoul, Republic of Korea. Electronic address: chonyeong@yuhs.ac.
authors: Cho Nyeong
authors: CN
authors: Lee
authors: Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: icyup@yuhs.ac.
authors: Myung Up
authors: MU
authors: Kim
authors: Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: shindakjang@yuhs.ac.
authors: Won Sik
authors: WS
authors: Jang
authors: Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: hylee@yuhs.ac.
authors: Hyeyoung
authors: H
authors: Lee
authors: Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: yjim@yuhs.ac.
authors: Young Jae
authors: YJ
authors: Im
authors: Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: swhan@yuhs.ac.
authors: Sang Won
authors: SW
authors: Han
mesh_terms: D057868:Anastomotic Leak; D004322:Drainage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007682:Kidney Pelvis / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D017211:Treatment Failure; D014517:Ureteral Obstruction / Q000503:physiopathology / Q000601:surgery*; D014547:Urinary Diversion; D013520:Urologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods
keywords: Anastomotic leakage; Hydronephrosis; Radioisotope Renography; Urinary diversion; Urinoma