Correlation of three-dimensional computerized tomographic renal parenchymal volumetry with DTPA split renal function in prospective donors - A retrospective study

Introduction and objectives: Congenital ureteropelvic junction obstruction (UPJO) is the most common cause of hydronephrosis. Management protocols are based on the presence of symptoms and when the patient is asymptomatic the function of the affected kidney determines the line of treatment. Percutaneous nephrostomy (PCN) became a widely accepted procedure in children in the 1990s. The aim of the study was to evaluate the results of performing percutaneous nephrostomy (PCN) in all patients with UPJO and split renal function (SRF) of less than 10% in the affected kidney, because the management of such cases is still under debate. Methods:This prospective clinical trial was carried out at Dhaka Medical College Hospital from January 2014 to December 2016. Eighteen consecutive patients who underwent PCN for the treatment of unilateral UPJO were evaluated prospectively. In these children, ultrasonography was used for puncture and catheter insertion. Local anesthesia with sedation or general anesthesia was used for puncture. Pig tail catheters were employed. The PCN remained in situ for at least 4 weeks, during which patients received low-dose cephalosporin prophylaxis. Repeat renography was done after 4 weeks. When there was no significant improvement in split renal function (10% or greater) and PCN drainage (greater than 200 ml per day) then nephrectomies were performed otherwise pyeloplasties were performed. The patients were followed up after pyeloplasty with renograms at 3 months and 6 months post operatively. Results: All the patients had severe hydronephrosis during diagnosis and 14 patients with unilateral UPJO were improved after PCN drainage and underwent pyeloplasty. The rest four patients that did not show improvement in the SRF and total volume of urine output underwent nephrectomy. In the patients with unilateral UPJO who improved after PCN drainage, the SRF was increased to 26.4% ±8.6% (mean± SD) after four weeks and pyeloplasty was performed. At three and six months follow-up, SRF value was 29.2% ±8.5% and 30.8.2% ±8.8% respectively. Conclusion: Before planning of nephrectomy in poorly functioning kidneys (SRF < 10%) due to congenital UPJO, PCN drainage should be done to asses improvement of renal function. Bangladesh Journal of Urology, Vol. 20, No. 2, July 2017 p.61-64

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Clinical Value of Computer-Assisted Taylor Three-dimensional External Fixation in the Treatment of Tibiofibular Fracture (Preprint)

10.2196/preprints.20711 ◽

2020 ◽

Author(s):

Hongfeng Sheng ◽

Weixing Xu ◽

Bin Xu ◽

Hongpu Song ◽

Di Lu ◽

...

Keyword(s):

Retrospective Study ◽

Internal Fixation ◽

External Fixation ◽

External Fixator ◽

Theoretical Basis ◽

New Technology ◽

Three Dimensional ◽

Computer Assisted ◽

Clinical Value

UNSTRUCTURED The retrospective study of Taylor's three-dimensional external fixator for the treatment of tibiofibular fractures provides a theoretical basis for the application of this technology. The paper collected 28 patients with tibiofibular fractures from the Department of Orthopaedics in our hospital from March 2015 to June 2018. After the treatment, the follow-up evaluation of Taylor's three-dimensional external fixator for the treatment of tibiofibular fractures and concurrency the incidence of the disease, as well as the efficacy and occurrence of the internal fixation of the treatment of tibial fractures in our hospital. The results showed that Taylor's three-dimensional external fixator was superior to orthopaedics in the treatment of tibiofibular fractures in terms of efficacy and complications. To this end, the thesis research can be concluded as follows: Taylor three-dimensional external fixation in the treatment of tibiofibular fractures is more effective, and the incidence of occurrence is low, is a new technology for the treatment of tibiofibular fractures, it is worthy of clinical promotion.

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99mTc-DTPA dynamic SPECT and CT volumetry for measuring split renal function in live kidney donors

Annals of Nuclear Medicine ◽

10.1007/s12149-010-0349-y ◽

2010 ◽

Vol 24 (3) ◽

pp. 189-195 ◽

Cited By ~ 19

Author(s):

Chihoko Miyazaki ◽

Hiroshi Harada ◽

Noriyuki Shuke ◽

Atsutaka Okizaki ◽

Masayoshi Miura ◽

...

Keyword(s):

Renal Function ◽

Dynamic Spect ◽

Ct Volumetry ◽

Kidney Donors ◽

Split Renal Function

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Renal artery stenosis by three-dimensional magnetic resonance angiography in type 2 diabetics with uncontrolled hypertension and chronic renal insufficiency: Prevalence and effect on renal function

American Journal of Kidney Diseases ◽

10.1053/ajkd.2003.50043 ◽

2003 ◽

Vol 41 (2) ◽

pp. 351-359 ◽

Cited By ~ 15

Author(s):

Donna I. Myers ◽

Lynn J. Poole ◽

Khursheed Imam ◽

Paul J. Scheel ◽

Joseph A. Eustace

Keyword(s):

Renal Function ◽

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Renal Insufficiency ◽

Renal Artery ◽

Chronic Renal Insufficiency ◽

Three Dimensional ◽

Uncontrolled Hypertension ◽

Type 2 Diabetics

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Surgery-Related Outcomes and Postoperative Split Renal Function by Scintigraphy Evaluation in Robot-Assisted Partial Nephrectomy in Complex Renal Tumors: An Initial Case Series

Journal of Endourology ◽

10.1089/end.2014.0042 ◽

2015 ◽

Vol 29 (1) ◽

pp. 29-34 ◽

Cited By ~ 4

Author(s):

Kazushi Tanaka ◽

Junya Furukawa ◽

Katsumi Shigemura ◽

Nobuyuki Hinata ◽

Takeshi Ishimura ◽

...

Keyword(s):

Renal Function ◽

Partial Nephrectomy ◽

Case Series ◽

Renal Tumors ◽

Robot Assisted ◽

Split Renal Function

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Renal functional improvement after pediatric pyeloplasty in kidneys with split renal function less than 20%: a single institute experience

Annals of Pediatric Surgery ◽

10.1186/s43159-021-00084-w ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Elsayed Salih ◽

Ibrahim Abdelmaksoud ◽

Mohamed Elfeky ◽

Gamal Selmy ◽

Hussein Galal ◽

...

Keyword(s):

Renal Function ◽

Statistical Significance ◽

Functional Improvement ◽

Renal Unit ◽

Poor Renal Function ◽

Split Renal Function ◽

Renal Function Deterioration ◽

Number Of Patients ◽

The Mean

Abstract Background Pediatric pyeloplasty in ureteropelvic junction obstruction (UPJO) is indicated in renal impaired drainage or renal function deterioration. The improvement of renal function after pediatric pyeloplasty is still controversial in poorly functioning kidneys. Past studies on poorly functioning kidneys had a variable SRF specification, and these studies often had a limited number of patients so that they did not achieve statistical significance. The study aims to detect the renal functional improvement after pediatric Anderson-Hynes pyeloplasty (AHP) with split renal function (SRF) less than 20% (poor renal function). Results A retrospective study included 46 pediatric patients with unilateral UPJO who underwent open AHP with SRF < 20% on a renal isotope scan from August 2012 to October 2018. Success was defined based on either improvement in symptoms, improvement in drainage on postoperative renography, and/or improvement or stability in SRF on the renal scan done 6 months postoperatively and yearly thereafter. Deterioration of SRF by more than 5% was deemed to be deterioration. An increase in SRF of more than 5% was deemed to be an improvement. A total of 46 patients with a mean age of 32 months with poor renal function on isotope renogram (SRF < 20%) were included. All patients had an obstructive pattern on the preoperative radionuclide scans. The median preoperative SRF was 9.26%. The mean (range) follow-up was 30 months. The success rate was 91.3%. Three patients underwent redo pyeloplasty, whereas a secondary nephrectomy was necessary for one. The remaining (42) patients showed stability or improvement of SRF with no further symptoms. Renal scintigraphy at 6 and 12 months after surgery revealed significantly increased SRF compared to preoperative one. Conclusion Poorly functioning renal unit with SRF < 20% can show functional improvement and recoverability after pediatric pyeloplasty.

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The Value of Split Renal Function in Severe Neonatal and Infant Pelviureteric Obstruction Managed by Percutaneous Nephrostomy

European Journal of Pediatric Surgery ◽

10.1055/s-2008-1066526 ◽

1996 ◽

Vol 6 (05) ◽

pp. 274-276 ◽

Cited By ~ 2

Author(s):

G. Audry ◽

C. Boyer ◽

C. Grapin ◽

J. Montagne ◽

L. Boccon-Gibod ◽

...

Keyword(s):

Renal Function ◽

Percutaneous Nephrostomy ◽

Split Renal Function

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Tumor volume and tumor crossing of the axial renal midline predict renal function after robotic partial nephrectomy

Scientific Reports ◽

10.1038/s41598-021-01539-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Haruyuki Ohsugi ◽

Kyojiro Akiyama ◽

Hisanori Taniguchi ◽

Masaaki Yanishi ◽

Motohiko Sugi ◽

...

Keyword(s):

Renal Function ◽

Partial Nephrectomy ◽

Tumor Volume ◽

Characteristic Curve ◽

Three Dimensional ◽

Scoring Systems ◽

Renal Tumors ◽

Perioperative Outcomes ◽

Robotic Partial Nephrectomy ◽

Perioperative Morbidity

AbstractThere are several nephrometry scoring systems for predicting surgical complexity and potential perioperative morbidity. The R.E.N.A.L. scoring system, one of the most well-known nephrometry scoring systems, emphasizes the features on which it is based (Radius, Exophytic/endophytic, Nearness to collecting system or sinus, Anterior/posterior, and Location relative to polar lines). The ability of these nephrometry scoring systems to predict loss of renal function after robotic partial nephrectomy (RPN) remains controversial. Therefore, we verified which combination of factors from nephrometry scoring systems, including tumor volume, was the most significant predictor of postoperative renal function. Patients who underwent RPN for cT1 renal tumors in our hospital were reviewed retrospectively (n = 163). The preoperative clinical data (estimated glomerular filtration rate [eGFR], comorbidities, and nephrometry scoring systems including R.E.N.A.L.) and perioperative outcomes were evaluated. We also calculated the tumor volume using the equation applied to an ellipsoid by three-dimensional computed tomography. The primary outcome was reduced eGFR, which was defined as an eGFR reduction of ≥ 20% from baseline to 6 months after RPN. Multivariable logistic regression analyses were used to evaluate the relationships between preoperative variables and reduced eGFR. Of 163 patients, 24 (14.7%) had reduced eGFR. Multivariable analyses indicated that tumor volume (cutoff value ≥ 14.11 cm3, indicating a sphere with a diameter ≥ approximately 3 cm) and tumor crossing of the axial renal midline were independent factors associated with a reduced eGFR (odds ratio [OR] 4.57; 95% confidence interval [CI] 1.69–12.30; P = 0.003 and OR 3.50; 95% CI 1.30–9.46; P = 0.034, respectively). Our classification system using these two factors showed a higher area under the receiver operating characteristic curve (AUC) than previous nephrometry scoring systems (AUC = 0.786 vs. 0.653–0.719), and it may provide preoperative information for counseling patients about renal function after RPN.

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