استفاده مجدد از داخل مجرای ادراری برای مهار اولیه مهاری در نوزادان زیر 1 سال

Ureteric reimplantation in infants under 1 year of age is a safe and effective option for managing POM that requires intervention, and compares favorably with those undergoing reimplantation over 1 year of age.Table. Summary of preoperative characteristics and postoperative results.Study group (reimplanted <12 months)Comparison group (reimplanted >12 months)p (study vs. comparison group)PreoperativeTotal34 (71%)14 (29%)UTI16 (47%)11 (79%)0.047*Ipsilateral function < 45%a,b13 (42%)a8 (62%)b0.22Renal impairment (raised creatinine)1 (3%)0–Temporizing operation10 (29%)3 (21%)0.57Age at reimplantation in months, median (range)5.2 (0.1–9.2)48.1 (12.8–131.1)<0.001*Time from diagnosis to reimplantation in months, median (range)3.4 (0.1–8.6)3.8 (0.1–106)0.75PostoperativeFollow-up (years)–median (range)5.5 (1.1–12.4)4.0 (1.3–10.7)0.34Redo surgery for restenosis1 (3%)2 (14%)0.05*Decline in renal functionc1 (3%)1 (7%)Improved renal functiond2 (6%)2 (14%)0.52Stable impaired renal functiond13 (38%)6 (43%)UTIe5 (15%)2 (14%)0.05* favors infantsLUTDf4 (12%)3 (21%)0.37Hypertension3 (9%)00.25Note. Values are n (%) unless otherwise stated. LUTD = lower urinary tract dysfunction; UTI = urinary tract infection.* Significant p value (<0.05).aOf cases with a functional contralateral kidney (3 single kidneys excluded).bOf cases with Mag3 done (1 case > 12 months excluded).cIncludes newly raised creatinine, and decline in ipsilateral function in cases with normal ipsilateral function preoperatively.dOf cases with raised serum creatinine preoperatively and/or reduced ipsilateral function preoperatively.eExcludes JJ stent-associated UTI.fOf cases over toilet-training age at end of follow-up.