Pelvis Peristalsis Of Hydronephrosis Caused By UPJO In Children And The Correlation With Prognosis

Objective:To analyze the pelvis peristalsis frequency in children with hydronephrosis,and to analyze the correlation between pelvis peristalsis and the degree of hydronephrosis,anteroposterior diameter(APD),age,weight and other factors,meanwhile the correlation between postoperative percentage of improvement in anteroposterior diameter(PI-APD)and degree of hydronephrosis or pelvis peristalsis frequency was investigated.Methods:From Oct 2015 to Sep 2017,data of children with unilateral UPJO hydronephrosis who underwent laparoscopic pyeloplasty was collected,pelvis peristalsis frequency of 2 min was recorded after exposing the pelvis.APD and PI-APD were followed 12 months postoperative.All children were divided into symptomatic group and asymptomatic group according to their clinical manifestations,such as renal area pain or abdominal pain.Degree of hydronephrosis were divided into mild(SFU grade I),moderate(SFU II-III)and severe(SFU IV)according to SFU classification system.ANOVA was used to compare the pelvis peristalsis frequency,decrease of APD and PI-APD between different degrees of hydronephrosis,t test was used to compare weight,preoperative APD and pelvis peristalsis frequency among different symptom groups.Correlation analysis was used to analyze the correlation between pelvis peristalsis frequency and degree of hydronephrosis,APD or other factors in different degree of hydronephrosis or symptomatic and asymptomatic group.Meanwhile,Pearson test was used to analyze the correlation between pelvis peristalsis frequency and PI-APD.Results:A total of 50 children were included,of which 36 got follow up 1 year after surgery.Pelvis 2min peristalsis frequency between different degree of hydronephrosis(mild: 8.1±3.3,n=9;moderate: 6.3±3.5,n=9;severe: 7.8±3.9,n= 32)had no significant difference(F=0.65,P=0.527);There was no significant difference in the frequency of pelvis peristalsis between the symptomatic group and the asymptomatic group(symptomatic group: 8.4±4.2,asymptomatic group: 7.1±3.4),P=0.232.No statistical correlation was observed between pelvis peristalsis and degree of hydronephrosis,APD,thickness of renal cortex,age or body weight(P > 0.05).In the study of prognostic relevance,the frequency of renal pelvis peristalsis recorded during the operation was not correlated with PI-APD in different degree of hydronephrosis,so as in symptomatic group and asymptomatic group.Preoperative hydronephrosis degree were correlated with PI-APD(r=0.54,P =0.001).PI-APD of severe hydronephrosis(0.48±0.29,n=23)was significantly higher than that of mild hydronephrosis(0.21±0.20,n=8),P =0.001.Conclusions:For children with different degrees of hydronephrosis caused by UPJO,the pelvis peristalsis frequency recorded during laparoscopic pyeloplasty was not correlated with hydronephrosis degree,age or PI-APD.No statistical difference of the pelvis peristalsis frequency was observed between different degree of hydronephrosis.For children with clinical symptoms or without clinical symptoms and children with different degree of hydronephrosis,there is no correlation between the frequency of renal pelvis peristalsis recorded during laparoscopic pyeloplasty and postoperative PI-APD.The preoperative degree of hydronephrosis is positively correlated with PI-APD.