Differences between intrinsic and extrinsic XXXX related to crossing vessels: histology and functional analyses.

@entity1 @entity32 @entity82 @entity1184 @entity4145
PURPOSE: In @entity1 , @entity4145 ( @entity4145 ) is mostly caused by intrinsic factors (IUPJO); extrinsic @entity4145 are rare and often due to crossing vessels (CVs). METHODS: We retrospectively reviewed all data of @entity1 with @entity4145 that underwent surgery in our institution from 2004 to 2011. Analyses included age at surgery, gender, preoperative and postoperative results of ultrasound and renal scans [differential renal function (DRF); signs of obstruction], and pathology reports. Available histological specimens of cases with CV were compared to a random selection of intrinsic cases in a blinded fashion. After additional Masson's trichrome staining, the specimens were scored for @entity82 , muscular @entity1184 , and @entity32 . RESULTS: Out of 139 @entity1 with @entity4145 , 39 cases were associated with CV. Median age at surgery was 68  months (range 2-194) in the CV group and 11.5  months (range 0-188) in IUPJO group. Laparoscopic dismembered pyeloplasty (LDMP) was carried out in 134 and open DMP in five @entity1 . Preoperative ultrasound identified 28/39 cases with CV. DRF below 40  % was more frequently seen in CV @entity1 (p  =  0.020). Histological analyses revealed no differences between the CV and IUPJO specimens in total. CV @entity1 with higher grades of muscular @entity1184 had lower preoperative DRF, compared to those with higher preoperative DRF (p  =  0.026). Functional recovery after (L)DMP was excellent in both groups. CONCLUSION: We could not find any significant histological differences between CV and IUPJO in @entity1 . To obtain excellent functional recovery, surgical procedures with a definite correction of the UPJ should be preferred in paediatric @entity1 with CV.
