Abstract
Purpose
To explore the role of the Whitaker test in evaluating the postoperative outcome of upper urinary tract reconstruction surgery in patients carrying a nephrostomy tube after surgery.
Patients and methods
This was a prospective observational study performed in 42 patients with nephrostomy tube undergoing the Whitaker test after upper urinary tract reconstruction surgery between January 2020 and December 2021. Data on clinical information, the Whitaker test and surgical procedure were collected prospectively, and the long-term follow-up results were analysed retrospectively.
Results
The 46 ureters of 42 patients (right 16, left 22, bilateral 4) underwent six common upper urinary tract surgical reconstruction procedures and one combined procedure, including pyeloplasty, ureteroureterostomy, lingual mucosal onlay graft, appendiceal onlay flap, ureteral reimplantation, Boari flap, and ipsilateral lingual mucosal onlay graft combined ureteral reimplantation. All patients underwent the Whitaker test successfully without any discomfort after examination. The postoperative Whitaker test showed 43 kidneys without obstruction and 3 kidneys with obstruction. At a median follow-up of 18 months (range 13–31), the follow-up results showed that the overall success rate of the surgery was 100% (46/46). Concerning the concordance Whitaker test and follow-up results, the observed proportion of agreement was 93.5% (43/46).
Conclusion
The Whitaker test can achieve similar consistency with the long-term follow-up results after upper urinary tract reconstruction surgery and can be used as a tool to evaluate the surgical efficacy of upper urinary tract reconstruction surgery, which can provide a prognostic efficacy evaluation for patients carrying a nephrostomy tube after surgery.
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Data availability
The data that support the findings of this study are available upon request from the corresponding author.
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Funding
This work was supported by Wuhan Union Hospital (CN, Grant No.2021xhlcyj11) and Wuhan Municipal Science and Technology Bureau (CN, Grant No.2020020601012222) to Bing Li.
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BL had full access to all the data in the study and took responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: JC, YX, BL; Acquisition of data: JC, XG, MY, YL, SC, YZ, ZL; Analysis and interpretation of data: JC, XG, YL; Drafting of the manuscript: JC, XG, XX, BL; Critical revision of the manuscript for important intellectual content: MY, YL, SC, YZ, ZL, YX; Statistical analysis: JC, XG; Obtaining funding: BL; Administrative, technical, or material support: ZL, YX, BL; Supervision: YX, BL.
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This study was approved by the Ethics Committee of Huazhong University of Science and Technology Affiliated Union Hospital (No.20210647).
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Chen, J., Gao, X., Yang, M. et al. The Whitaker test: a predictive tool for evaluating the surgical efficacy of upper urinary tract reconstruction in patients carrying a nephrostomy tube after surgery. Int Urol Nephrol 56, 1817–1824 (2024). https://doi.org/10.1007/s11255-023-03927-0
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DOI: https://doi.org/10.1007/s11255-023-03927-0