Applying the pyeloplasty predictive score in patients with ureteropelvic junction obstruction.

IF 1.9 3区 医学 Q2 PEDIATRICS
Ana Caroline Andrade De Melo, Paulo Cesar Koch Nogueira, Marcia Emilia Francisco Shida, Maria Luiza Dautro Moreira do Val, Maria Cristina Andrade, Luiz Gonzaga de Freitas Filho, Mila Torii Corrêa Leite
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引用次数: 0

Abstract

Background: Ureteropelvic junction obstruction (UPJO) is an anatomical lesion in the renal collecting system and is one of the most common congenital causes of hydronephrosis, occurring in 1-5 % of pregnancies. Surgical predictive scores have been extensively studied as a promising way to assist and optimize management in cases of UPJO.

Objective: Apply the pyeloplasty predictive score and evaluate its effectiveness in patients with UPJO treated at a tertiary care hospital.

Study design: The Pyeloplasty Prediction Score (PPS) was retrospectively applied to patients diagnosed with UPJO and treated at a tertiary care hospital. The PPS is based on the Society for Fetal Urology grading system, the anteroposterior diameter of the pelvis, and the absolute percentage of the difference in renal length. The PPS ranges from 0 to 12 and is calculated by adding each of the scored variables, classifying surgical risk as low, intermediate, and high.

Results: Out of the 48 kidney units studied, 18 did not undergo surgical treatment, and 30 underwent pyeloplasty. The number of units with low, intermediate, and high non-surgical PPS was 8, 8, and 2, respectively, and surgical PPS was 1, 8, and 21. The sensitivity of the PPS was 96.67 %, and the specificity was 44.44 %. The positive predictive value was 74.36 %, and the negative predictive value was 88.89 %.

Discussion: The majority of surgical kidney units had a high score. The only patient operated on with low risk had associated vesicoureteral reflux in the same unit. Half of the non-surgical patients had a low score. The two high-risk non-surgical cases had megacalicosis as the final diagnosis.

Conclusion: PPS may aid the clinical practice of UPJO due to its high sensitivity in high and low scores, necessitating an individualized clinical and radiological assessment in intermediate-risk cases.

肾盂输尿管连接处梗阻患者肾盂成形术预测评分的应用。
背景:肾盂输尿管连接处梗阻(UPJO)是肾收集系统的一种解剖病变,是肾盂积水最常见的先天性原因之一,发生率为1- 5%。手术预测评分作为一种有前途的方法被广泛研究,以协助和优化UPJO病例的管理。目的:应用肾盂成形术预测评分并评价其在三级医院UPJO患者中的应用效果。研究设计:回顾性应用肾盂成形术预测评分(PPS)对诊断为UPJO并在三级医院治疗的患者进行评估。PPS是基于胎儿泌尿学学会分级系统、骨盆前后径和肾脏长度差异的绝对百分比。PPS的范围从0到12,通过将每个评分变量相加计算,将手术风险分为低、中、高三个级别。结果:在研究的48个肾脏单位中,18个没有接受手术治疗,30个接受了肾盂成形术。非手术PPS低、中、高的单位分别为8、8、2个,手术PPS为1、8、21个。PPS的敏感性为96.67%,特异性为44.44%。阳性预测值为74.36%,阴性预测值为88.89%。讨论:大多数肾脏手术单元得分较高。同一单位中唯一的低风险手术患者有膀胱输尿管反流。一半的非手术患者得分较低。2例非手术高危患者最终诊断为巨钙化症。结论:PPS对高、低分的敏感性较高,有助于UPJO的临床应用,对中危病例有必要进行个体化的临床和影像学评估。
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来源期刊
Journal of Pediatric Urology
Journal of Pediatric Urology PEDIATRICS-UROLOGY & NEPHROLOGY
CiteScore
3.70
自引率
15.00%
发文量
330
审稿时长
4-8 weeks
期刊介绍: The Journal of Pediatric Urology publishes submitted research and clinical articles relating to Pediatric Urology which have been accepted after adequate peer review. It publishes regular articles that have been submitted after invitation, that cover the curriculum of Pediatric Urology, and enable trainee surgeons to attain theoretical competence of the sub-specialty. It publishes regular reviews of pediatric urological articles appearing in other journals. It publishes invited review articles by recognised experts on modern or controversial aspects of the sub-specialty. It enables any affiliated society to advertise society events or information in the journal without charge and will publish abstracts of papers to be read at society meetings.
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