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Wahyudi I, Tendi W, Rahman F, Situmorang GR, Rodjani A. Minimal Invasive Treatment in Pelvic-Ureteric Junction Obstruction: A Comprehensive Review. Res Rep Urol 2021; 13:573-580. [PMID: 34408990 PMCID: PMC8364382 DOI: 10.2147/rru.s268569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 07/27/2021] [Indexed: 12/22/2022] Open
Abstract
Pelvic-ureteric junction obstruction (PUJO) is a common condition, and one of the lead causes of hydronephrosis in children. Currently, the gold standard treatment of PUJO is open surgery using the Anderson–Hynes-modified dismembered pyeloplasty technique. However, with the advancement of medical technology, several minimal invasive approaches were developed, including endoscopic, laparoscopic, and robotic approach, from which the best choice of surgical technique was yet to be determined. Considering the advantages and disadvantages of these methods, the recommended option is to tailor the best surgical approach to each individual patient, and to the surgeons’ preference and experience. Considering these recent advances, a new algorithm is proposed to choose the best minimal invasive modalities invasive treatment to treat PUJO.
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Affiliation(s)
- Irfan Wahyudi
- Department of Urology, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.,Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - William Tendi
- Department of Urology, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.,Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Fakhri Rahman
- Department of Urology, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.,Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Gerhard Reinaldi Situmorang
- Department of Urology, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.,Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Arry Rodjani
- Department of Urology, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.,Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Khan NE, Ling A, Raske ME, Harney LA, Carr AG, Field A, Harris AK, Williams GM, Dehner LP, Messinger YH, Hill DA, Schultz KAP, Stewart DR. Structural renal abnormalities in the DICER1 syndrome: a family-based cohort study. Pediatr Nephrol 2018; 33:2281-2288. [PMID: 30178239 PMCID: PMC6203641 DOI: 10.1007/s00467-018-4040-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 07/20/2018] [Accepted: 08/02/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND The DICER1 syndrome is a tumor-predisposition disorder caused by germline pathogenic variation in DICER1 and is associated with cystic nephroma and other renal neoplasms. Dicer1 mouse and rare human DICER1 syndrome case reports describe structural kidney and collecting system anomalies. We investigated renal function and the frequency of structural abnormalities of the kidney and collecting system in individuals with germline loss-of-function variants in DICER1. METHODS In this family-based cohort study, prospectively ascertained germline DICER1-mutation carriers (DICER1-carriers) and unaffected family controls were evaluated at the National Institutes of Health Clinical Center with renal ultrasound and comprehensive laboratory testing. Two radiologists reviewed the imaging studies from all participants for structural abnormalities, cysts, and tumors. RESULTS Eighty-nine DICER1-carriers and 61 family controls were studied. Renal cysts were detected in 1/33 DICER1-carrier children without history of cystic nephroma. Similar proportions of adult DICER1-carriers (8/48; 17%) and controls (11/50; 22%) had ultrasound-detected renal cysts (P = 0.504). 8/89 (9%) DICER1-carriers harbored ultrasound-detected structural abnormalities of varying severity within the collecting system or kidney, nephrolithiasis, or nephrocalcinosis. None of the family controls (0/61) had similar findings on ultrasound (P = 0.02). No meaningful differences in renal laboratory values between DICER1-carriers and unaffected family controls were observed. CONCLUSIONS Our report is the first to systematically characterize renal function and anatomy in a large prospective cohort of DICER1-carriers and DICER1-negative family controls. DICER1-carriers may be at increased risk of structural anomalies of the kidney or collecting system. The role for DICER1 in renal morphogenesis merits additional investigation.
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Affiliation(s)
- Nicholas E. Khan
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, 20850
| | - Alexander Ling
- Clinical Center, National Institutes of Health, Bethesda, MD, 20892
| | - Molly E. Raske
- Department of Radiology, Children’s Minnesota, Minneapolis, MN 55404
| | | | | | - Amanda Field
- Division of Pathology and Center for Clinical and Immunology Research, Children’s National Health System, Washington, DC, 20010;,Department of Integrative Systems Biology, George Washington University School of Medicine and Health Sciences, Washington, DC, 20037
| | - Anne K. Harris
- Cancer and Blood Disorders, Children’s Minnesota, Minneapolis, MN 55404;,International Pleuropulmonary Blastoma Registry, Minneapolis, MN, 55404;,International Ovarian and Testicular Stromal Tumor Registry, Minneapolis, MN, 55404
| | - Gretchen M. Williams
- Cancer and Blood Disorders, Children’s Minnesota, Minneapolis, MN 55404;,International Pleuropulmonary Blastoma Registry, Minneapolis, MN, 55404
| | - Louis P. Dehner
- Department of Pathology, Washington University in St. Louis, St. Louis, MS, 63130
| | - Yoav H. Messinger
- Cancer and Blood Disorders, Children’s Minnesota, Minneapolis, MN 55404;,International Pleuropulmonary Blastoma Registry, Minneapolis, MN, 55404
| | - D. Ashley Hill
- Division of Pathology and Center for Clinical and Immunology Research, Children’s National Health System, Washington, DC, 20010;,Department of Integrative Systems Biology, George Washington University School of Medicine and Health Sciences, Washington, DC, 20037
| | - Kris Ann P. Schultz
- Cancer and Blood Disorders, Children’s Minnesota, Minneapolis, MN 55404;,International Pleuropulmonary Blastoma Registry, Minneapolis, MN, 55404;,International Ovarian and Testicular Stromal Tumor Registry, Minneapolis, MN, 55404
| | - Douglas R. Stewart
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, 20850
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