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Objective <p>To investigate the risk factors of recurrent obstruction after unilateral laparoscopic pyeloplasty in children to reduce the occurrence of postoperative recurrent obstruction.</p> Methods <p>We retrospectively analyzed data from 106 children with hydronephrosis diagnosed with unilateral ureteropyeloplasty seen in our hospital between June 2017 and June 2022. A unilateral laparoscopic pyeloplasty was performed by the same experienced chief physician and the same surgical team. After a 24 month follow-up, the patients were divided into a reobstruction group and a non-reobstruction group according to whether there was recurrent obstruction during the postoperative follow-up, and the clinical data was analyzed.</p> Results <p>Among 106 children with unilateral UPJO 11 (10.3%) had recurrent obstruction after surgery, the re-obstruction group. The remainder (95/106) (89.7%) of the children did not have recurrent obstruction after surgery and comprised the non- reobstruction group. Univariate analysis showed that there were significant differences in preterm birth history, preoperative renal function, preoperative APD, and postoperative urinary tract infection between the two groups. There was no significant difference between the two groups in age, sex, weight, operative side, preoperative renal cortical thickness, operation duration, urinary catheter indwelling time, or postoperative drainage. Multivariate regression analysis showed that preoperative renal function (OR:1.13, <i>p</i> = 0.014) and postoperative urinary tract infection (OR:7.77, <i>p</i> = 0.009) were independent risk factors for postoperative reobstruction. ROC analysis showed that the AUC of preoperative renal function in predicting postoperative reobstruction was 0.84 (95%CI:0.74 ~ 0.93, <i>p</i> &lt; 0.001). The AUC for postoperative urinary tract infection was 0.70 (95%CI:0.52 ~ 0.88, <i>p</i> = 0.031). The combined AUC was 0.86 (95%CI:0.77 ~ 0.96, <i>p</i> &lt; 0.001), the sensitivity was 83%, and the specificity was 82%.</p> Conclusion <p>Preoperative renal function and postoperative urinary tract infection are independent risk factors for recurrent obstruction after unilateral laparoscopic pyeloplasty in children. The analysis of preoperative renal function and postoperative urinary tract infection can help predict the recurrence of postoperative obstruction.</p>

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Analysis of the relevant risk factors for reobstruction after laparoscopic unilateral pyeloplasty in children

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  • 发表日期：

    2026年8月5日

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  • Changwei Wu,
  • Xv Cui,
  • Zhiqiang Chen,
  • Liu Chen,
  • Chaoming Zhou

摘要

Objective

To investigate the risk factors of recurrent obstruction after unilateral laparoscopic pyeloplasty in children to reduce the occurrence of postoperative recurrent obstruction.

Methods

We retrospectively analyzed data from 106 children with hydronephrosis diagnosed with unilateral ureteropyeloplasty seen in our hospital between June 2017 and June 2022. A unilateral laparoscopic pyeloplasty was performed by the same experienced chief physician and the same surgical team. After a 24 month follow-up, the patients were divided into a reobstruction group and a non-reobstruction group according to whether there was recurrent obstruction during the postoperative follow-up, and the clinical data was analyzed.

Results

Among 106 children with unilateral UPJO 11 (10.3%) had recurrent obstruction after surgery, the re-obstruction group. The remainder (95/106) (89.7%) of the children did not have recurrent obstruction after surgery and comprised the non- reobstruction group. Univariate analysis showed that there were significant differences in preterm birth history, preoperative renal function, preoperative APD, and postoperative urinary tract infection between the two groups. There was no significant difference between the two groups in age, sex, weight, operative side, preoperative renal cortical thickness, operation duration, urinary catheter indwelling time, or postoperative drainage. Multivariate regression analysis showed that preoperative renal function (OR:1.13, p = 0.014) and postoperative urinary tract infection (OR:7.77, p = 0.009) were independent risk factors for postoperative reobstruction. ROC analysis showed that the AUC of preoperative renal function in predicting postoperative reobstruction was 0.84 (95%CI:0.74 ~ 0.93, p < 0.001). The AUC for postoperative urinary tract infection was 0.70 (95%CI:0.52 ~ 0.88, p = 0.031). The combined AUC was 0.86 (95%CI:0.77 ~ 0.96, p < 0.001), the sensitivity was 83%, and the specificity was 82%.

Conclusion

Preoperative renal function and postoperative urinary tract infection are independent risk factors for recurrent obstruction after unilateral laparoscopic pyeloplasty in children. The analysis of preoperative renal function and postoperative urinary tract infection can help predict the recurrence of postoperative obstruction.