A Rapid Special Staining Technique for Identification of Normal Ureter by Frozen Section in Children With Ureteropelvic Junction Obstruction
Background The exact etiology of ureteropelvic junction obstruction (UPJO) is unknown, and inadequate excision of the narrow segment has been proposed as a cause of failure in 5% to 7% of cases of pyeloplasty. Aims To study whether frozen section can be useful to detect normal ureter distal to UPJO...
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| Veröffentlicht in: | Pediatric and developmental pathology 2019-12, Vol.22 (6), p.558-565 |
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| container_title | Pediatric and developmental pathology |
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| creator | Babu, Ramesh Vittalraj, Pavithra Sundaram, Sandhya Pothankulankara Manjusha, Mullappali Ramanan, Venkat Sai, Venkata |
| description | Background
The exact etiology of ureteropelvic junction obstruction (UPJO) is unknown, and inadequate excision of the narrow segment has been proposed as a cause of failure in 5% to 7% of cases of pyeloplasty.
Aims
To study whether frozen section can be useful to detect normal ureter distal to UPJO during pyeloplasty.
Methods
Histological sections from 31 patients with UPJO were analyzed for collagen to muscle ratio (CMR) on conventional (formalin) and rapid (frozen section) Masson’s trichrome staining. Pathological findings were correlated with postoperative outcomes analyzed at 1-year follow-up and expressed as excellent, moderate, or mild improvement, static and deterioration based on ultrasound grade, differential renal function, and renogram drainage pattern.
Results
There was a very strong positive correlation (r = .94; P = .001) between CMR by conventional and rapid frozen Masson’s trichrome staining. There was a very strong negative correlation between pyeloplasty outcomes and CMR on conventional staining (r = −.94; P = .001) or rapid frozen Masson’s trichrome staining (r = −.91; P = .001). Regression analysis revealed that a CMR of 1.2 or less (95% confidence interval: 1.9–0.7) was associated with a successful outcome.
Conclusions
It is feasible to intraoperatively identify normal ureter distal to UPJO using CMR analysis on the novel rapid frozen section technique reported. |
| doi_str_mv | 10.1177/1093526619863538 |
| format | Article |
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The exact etiology of ureteropelvic junction obstruction (UPJO) is unknown, and inadequate excision of the narrow segment has been proposed as a cause of failure in 5% to 7% of cases of pyeloplasty.
Aims
To study whether frozen section can be useful to detect normal ureter distal to UPJO during pyeloplasty.
Methods
Histological sections from 31 patients with UPJO were analyzed for collagen to muscle ratio (CMR) on conventional (formalin) and rapid (frozen section) Masson’s trichrome staining. Pathological findings were correlated with postoperative outcomes analyzed at 1-year follow-up and expressed as excellent, moderate, or mild improvement, static and deterioration based on ultrasound grade, differential renal function, and renogram drainage pattern.
Results
There was a very strong positive correlation (r = .94; P = .001) between CMR by conventional and rapid frozen Masson’s trichrome staining. There was a very strong negative correlation between pyeloplasty outcomes and CMR on conventional staining (r = −.94; P = .001) or rapid frozen Masson’s trichrome staining (r = −.91; P = .001). Regression analysis revealed that a CMR of 1.2 or less (95% confidence interval: 1.9–0.7) was associated with a successful outcome.
Conclusions
It is feasible to intraoperatively identify normal ureter distal to UPJO using CMR analysis on the novel rapid frozen section technique reported.</description><identifier>ISSN: 1093-5266</identifier><identifier>EISSN: 1615-5742</identifier><identifier>DOI: 10.1177/1093526619863538</identifier><identifier>PMID: 31315518</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Child ; Child, Preschool ; Female ; Follow-Up Studies ; Frozen Sections ; Humans ; Infant ; Intraoperative Care ; Male ; Staining and Labeling - methods ; Treatment Outcome ; Ureter - pathology ; Ureter - surgery ; Ureteral Obstruction - diagnosis ; Ureteral Obstruction - pathology ; Ureteral Obstruction - surgery</subject><ispartof>Pediatric and developmental pathology, 2019-12, Vol.22 (6), p.558-565</ispartof><rights>2019, Society for Pediatric Pathology All rights reserved</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c290t-a687f5ed5fd8a2b126728e392e5a5d4aa733e41db18f45c2e4239c53c3be80073</cites><orcidid>0000-0002-4831-5795</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1093526619863538$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1093526619863538$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21799,27903,27904,43600,43601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31315518$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Babu, Ramesh</creatorcontrib><creatorcontrib>Vittalraj, Pavithra</creatorcontrib><creatorcontrib>Sundaram, Sandhya</creatorcontrib><creatorcontrib>Pothankulankara Manjusha, Mullappali</creatorcontrib><creatorcontrib>Ramanan, Venkat</creatorcontrib><creatorcontrib>Sai, Venkata</creatorcontrib><title>A Rapid Special Staining Technique for Identification of Normal Ureter by Frozen Section in Children With Ureteropelvic Junction Obstruction</title><title>Pediatric and developmental pathology</title><addtitle>Pediatr Dev Pathol</addtitle><description>Background
The exact etiology of ureteropelvic junction obstruction (UPJO) is unknown, and inadequate excision of the narrow segment has been proposed as a cause of failure in 5% to 7% of cases of pyeloplasty.
Aims
To study whether frozen section can be useful to detect normal ureter distal to UPJO during pyeloplasty.
Methods
Histological sections from 31 patients with UPJO were analyzed for collagen to muscle ratio (CMR) on conventional (formalin) and rapid (frozen section) Masson’s trichrome staining. Pathological findings were correlated with postoperative outcomes analyzed at 1-year follow-up and expressed as excellent, moderate, or mild improvement, static and deterioration based on ultrasound grade, differential renal function, and renogram drainage pattern.
Results
There was a very strong positive correlation (r = .94; P = .001) between CMR by conventional and rapid frozen Masson’s trichrome staining. There was a very strong negative correlation between pyeloplasty outcomes and CMR on conventional staining (r = −.94; P = .001) or rapid frozen Masson’s trichrome staining (r = −.91; P = .001). Regression analysis revealed that a CMR of 1.2 or less (95% confidence interval: 1.9–0.7) was associated with a successful outcome.
Conclusions
It is feasible to intraoperatively identify normal ureter distal to UPJO using CMR analysis on the novel rapid frozen section technique reported.</description><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Frozen Sections</subject><subject>Humans</subject><subject>Infant</subject><subject>Intraoperative Care</subject><subject>Male</subject><subject>Staining and Labeling - methods</subject><subject>Treatment Outcome</subject><subject>Ureter - pathology</subject><subject>Ureter - surgery</subject><subject>Ureteral Obstruction - diagnosis</subject><subject>Ureteral Obstruction - pathology</subject><subject>Ureteral Obstruction - surgery</subject><issn>1093-5266</issn><issn>1615-5742</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUlPwzAQhS0EYincOSEfuQS8xFmOqKIsQiDRVhwjx5lQo9QOdoJUfgM_GrcpHJA4zWjme096MwidUnJBaZpeUpJzwZKE5lnCBc920CFNqIhEGrPd0Id1tN4foCPv3wgJmoTsowNOORWCZofo6wo_y1ZXeNqC0rLB005qo80rnoFaGP3eA66tw3cVmE7XWslOW4NtjR-tWwZ-7qADh8sVnjj7CQZPQW0QbfB4oZvKhdmL7hZb0rbQfGiF73szcE-l71y_6Y_RXi0bDyfbOkLzyfVsfBs9PN3cja8eIsVy0kUyydJaQCXqKpOspCxJWQY8ZyCkqGIpU84hplVJszoWikHMeK4EV7yEjJCUj9D54Ns6GwL6rlhqr6BppAHb-4IxkeckYWKNkgFVznrvoC5ap5fSrQpKivUPir8_CJKzrXtfLqH6FfwcPQDRAHj5CsWb7Z0Jaf83_AaeZ5Ag</recordid><startdate>20191201</startdate><enddate>20191201</enddate><creator>Babu, Ramesh</creator><creator>Vittalraj, Pavithra</creator><creator>Sundaram, Sandhya</creator><creator>Pothankulankara Manjusha, Mullappali</creator><creator>Ramanan, Venkat</creator><creator>Sai, Venkata</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4831-5795</orcidid></search><sort><creationdate>20191201</creationdate><title>A Rapid Special Staining Technique for Identification of Normal Ureter by Frozen Section in Children With Ureteropelvic Junction Obstruction</title><author>Babu, Ramesh ; Vittalraj, Pavithra ; Sundaram, Sandhya ; Pothankulankara Manjusha, Mullappali ; Ramanan, Venkat ; Sai, Venkata</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c290t-a687f5ed5fd8a2b126728e392e5a5d4aa733e41db18f45c2e4239c53c3be80073</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Frozen Sections</topic><topic>Humans</topic><topic>Infant</topic><topic>Intraoperative Care</topic><topic>Male</topic><topic>Staining and Labeling - methods</topic><topic>Treatment Outcome</topic><topic>Ureter - pathology</topic><topic>Ureter - surgery</topic><topic>Ureteral Obstruction - diagnosis</topic><topic>Ureteral Obstruction - pathology</topic><topic>Ureteral Obstruction - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Babu, Ramesh</creatorcontrib><creatorcontrib>Vittalraj, Pavithra</creatorcontrib><creatorcontrib>Sundaram, Sandhya</creatorcontrib><creatorcontrib>Pothankulankara Manjusha, Mullappali</creatorcontrib><creatorcontrib>Ramanan, Venkat</creatorcontrib><creatorcontrib>Sai, Venkata</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric and developmental pathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Babu, Ramesh</au><au>Vittalraj, Pavithra</au><au>Sundaram, Sandhya</au><au>Pothankulankara Manjusha, Mullappali</au><au>Ramanan, Venkat</au><au>Sai, Venkata</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Rapid Special Staining Technique for Identification of Normal Ureter by Frozen Section in Children With Ureteropelvic Junction Obstruction</atitle><jtitle>Pediatric and developmental pathology</jtitle><addtitle>Pediatr Dev Pathol</addtitle><date>2019-12-01</date><risdate>2019</risdate><volume>22</volume><issue>6</issue><spage>558</spage><epage>565</epage><pages>558-565</pages><issn>1093-5266</issn><eissn>1615-5742</eissn><abstract>Background
The exact etiology of ureteropelvic junction obstruction (UPJO) is unknown, and inadequate excision of the narrow segment has been proposed as a cause of failure in 5% to 7% of cases of pyeloplasty.
Aims
To study whether frozen section can be useful to detect normal ureter distal to UPJO during pyeloplasty.
Methods
Histological sections from 31 patients with UPJO were analyzed for collagen to muscle ratio (CMR) on conventional (formalin) and rapid (frozen section) Masson’s trichrome staining. Pathological findings were correlated with postoperative outcomes analyzed at 1-year follow-up and expressed as excellent, moderate, or mild improvement, static and deterioration based on ultrasound grade, differential renal function, and renogram drainage pattern.
Results
There was a very strong positive correlation (r = .94; P = .001) between CMR by conventional and rapid frozen Masson’s trichrome staining. There was a very strong negative correlation between pyeloplasty outcomes and CMR on conventional staining (r = −.94; P = .001) or rapid frozen Masson’s trichrome staining (r = −.91; P = .001). Regression analysis revealed that a CMR of 1.2 or less (95% confidence interval: 1.9–0.7) was associated with a successful outcome.
Conclusions
It is feasible to intraoperatively identify normal ureter distal to UPJO using CMR analysis on the novel rapid frozen section technique reported.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>31315518</pmid><doi>10.1177/1093526619863538</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-4831-5795</orcidid></addata></record> |
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| ispartof | Pediatric and developmental pathology, 2019-12, Vol.22 (6), p.558-565 |
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| source | MEDLINE; SAGE Complete |
| subjects | Child Child, Preschool Female Follow-Up Studies Frozen Sections Humans Infant Intraoperative Care Male Staining and Labeling - methods Treatment Outcome Ureter - pathology Ureter - surgery Ureteral Obstruction - diagnosis Ureteral Obstruction - pathology Ureteral Obstruction - surgery |
| title | A Rapid Special Staining Technique for Identification of Normal Ureter by Frozen Section in Children With Ureteropelvic Junction Obstruction |
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