Endopyelotomy versus redo pyeoloplasty for management of failed pyeloplasty in children: A single center experience
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Read the article on jpedsurg.org ↗Article · Jun 2018 · 1 min read
In brief
In brief
Comparative study of 43 pediatric patients with failed pyeloplasty treated with either endopyelotomy (n=27) or redo pyeloplasty (n=16). Stricture length emerged as a key predictor: all failed endopyelotomies had strictures >15mm, while successful cases averaged 10mm versus 17.8mm in failures, suggesting redo pyeloplasty may be preferable for longer strictures.
Written by the GCMD Library team from the article.
Purpose
We compared endopyelotomy to redo pyeloplasty for the treatment of failed pyeloplasty in children to identify factors that may have an impact on outcome and favor one procedure over the other.
Methods
Of 43 patients with recurrent UPJO, EP was performed in 27 and RP was performed in 16. Age, gender, side, presentation of secondary UPJO, hospital stay, complications and success rates were compared. Success was defined as radiographic relief of obstruction as determined by ultrasound or diuretic renography at latest follow-up.
Results
Mean (Range) patient age was 7.2 years (range 6 months to 17 years) in EP (group 1) while 7.4 (range 6 months to 17 years) in RP (group 2). EP technique consisted of retrograde cold-knife in 17 patients, retrograde holmium laser in 8 and antegrade cold-knife in 2. RP was performed in 16 patients. All the patients with failed EP had a stricture greater than 15 mm. Mean length of the narrowed ureteral segment was 17.8 mm in the failed EP group vs 10 mm in the successful group (p