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The following is a summary of “Ureteropelvic Junction Obstruction Caused by Crossing Vessels in Infants and Young Children,” published in the March 2024 issue of Pediatrics by Zhao et al.
The present study aimed to comprehensively examine the clinical features associated with ureteropelvic junction obstruction (UPJO) attributable to crossing vessels (CV) in infants and young children.
A retrospective analysis was conducted on a cohort of children who underwent primary surgical intervention for UPJO. The patients were stratified into two groups based on the type of surgical procedure performed: laparoscopic pyeloplasty (LP) and open pyeloplasty (OP). Additionally, the patients were further categorized into two age groups: those aged ≤3 years and those aged >3 years. Cases of UPJO caused by CV were identified and analyzed.
The study encompassed a total of 747 patients, among whom 90 cases of CV-induced UPJO were identified. Interestingly, the detection rate of CV was notably higher in the LP group (78 out of 457 patients, 17.1%) compared to the OP group (12 out of 290 patients, 4.1%) (P<0.001). Furthermore, in the subgroup of patients aged ≤3 years, the rate of CV detection in the LP group (27 out of 144 patients, 18.8%) was significantly greater than that observed in the OP group (11 out of 274 patients, 4.0%) (P<0.001). Remarkably, in the LP group, there was no significant disparity between patients aged ≤3 years (27 out of 144 patients, 18.8%) and those aged >3 years (51 out of 313 patients, 16.3%) in terms of CV detection rate. The indications for surgical intervention varied between the two age groups, with progressive aggravation of hydronephrosis (77.8%) and symptomatic hydronephrosis (86.3%) being the primary reasons for surgery in the ≤3 and >3 age groups, respectively.
The distribution of CV-induced UPJO appears to be consistent across all age groups of children, underscoring that CV occurrence in infants and young children is not uncommon. Importantly, the findings suggest that LP may be preferable, as CV are susceptible to being overlooked during OP procedures.
Source: sciencedirect.com/science/article/abs/pii/S0022346824002057