儿童肾盂成形术后严重尿外渗的临床特点及预后分析OA北大核心CSTPCD

Objective To explore the clinical features and outcomes of massive urinary extravasation af-ter pyeloplasty in children.Methods From January 2016 to December 2023,the relevant clinical data were retrospectively reviewed for 18 children with massive urinary extravasation after pyeloplasty.Demographic pro-files,medical history,perioperative images,urinary extravasation during hospitalization,and treatment outcomes were recorded.Results There were 16 boys and 2 girls with an operative age of(6.03±4.79)year.Obstruc-tion was located at left(n=16)and right(n=2).Length of hospitalization stay was 20(13-24)day and median duration of massive postoperative urinary extravasation 2(1-20)day.In 17/18 children,abdominal drainage tube was retained for a median duration of 11(8-15)day.The highest volume of abdominal drainage fluid withinin a single day was 485(298-786)ml.Clavien-Dindo grade of postoperative complications was Ⅰ(n=8),Ⅱ(n=4)and Ⅲb(n=6).The frequency of reoperation during hospitalization was 33.33％(6/18).The perioperative APD were(4.11±1.83)and 2.40(1.58,4.53)cm with statistically significant differ-ence(Z=-2.628,P=0.009).Perioperative PTmin was 0.6(0.2,0.8)and(0.93±0.32)cm with statisti-cally significant difference(Z=-2.580,P=0.011).Perioperative ratio of APD/PT was 6.05(2.85-13.44)and 2.64(1.95-5.73)with statistically significant difference(Z=-2.940,P=0.002).Postopera-tive values of APD,PTmin,and APD/PT significantly improved as compared preoperatively.PI-APD was 20.95％(-0.45％,60.91％).There were two cases of postoperative re-obstruction.Overall success rate of operation was 88.89％(16/18).Conclusions Severe urinary extravasation after pyeloplasty may result in an extended duration of hospitalization and an elevated probability of reoperation.However,the occurrence of re-ob-struction after pyeloplasty with massive urine extravasation remains low.