Kokorkin O. Early diagnosis and surgical treatment of kidney and upper urinary tract abnormalities in children

The dissertation deals with the actual goal of improving the results of treatment children with congenital malformations of the kidneys and upper urinary tract due to increased diagnostic efficiency in the prenatal and postnatal periods, optimization of the tactics of dynamic observation and methods of surgical treatment. In the course of the conducted studies, high informative features of MRI was proved, as a refining method in the diagnosis of defects in the development of kidneys and upper urinary tract in fetuses. The morphostructural reconstruction of the upper urinary tract in the uncomplicated and complicated variants of the malformation with varying degrees of neuromuscular dysplasia has been studied. The importance of prognostic factors abnormalities of the urinary tract in early childhood is revealed. In predicting the clinical course of abnormalities of kidney and upper urinary tract advisable to take into account factors of obstetric history, results of fetus and newborn examination. Taking into account the results of multivariate regression analysis, it is proved that the formation of the defect subject to surgical correction depends on the presence of pelvis dilatation more 10 mm (OR=0,543, р<0,01), dilatation of the ureter more 10 mm (ОR=0,401, р<0,01), dilatation of the calix more 13 mm (ОR=1,065, р<0,01) and thinning of the parenchyma less 5 mm (ОR=0,976, р<0,01). The proposed treatment and diagnostic algorithms of defects in the development of kidneys and upper urinary tract allowed reducing the number of nephrureteroectomies and complications in the postoperative period.