Open Anderson Hynes Pyeloplasty in Ureteropelvic Junction Obstruction: An Institutional Experience

摘要

Introduction: Ureteropelvic junction obstruction (UPJO) is one of the common causes ofhydronephros is in children and adults. The cause may be congenital or acquired. The standardmanagement of UPJO has classically been an open Anderson-Hynes (A-H) dismemberedpyeloplasty. This study is an audit of A-H pyeloplasty done for patients with UPJO presentingto our institution.Methods: A retrospective analysis was done in the Urology unit, Tribhuvan UniversityTeaching Hospital from July 2013 to November 2014. All patients undergoing A-H pyeloplastywere included for review. Preoperative data regarding the demographics, presentation,diagnostic tools used, details of the surgery, postoperative complications, duration of hospitalstay and follow up findings were reviewed. Initial follow up was scheduled at two weeks,then at three months and at one year. At 3 months, DTPA renogram was obtained to assessthe function and clearance of the treated kidney.Results: The age of the patients ranged from 5 months to 69 years. Flank pain was the mostcommon presenting complain. Most of the patients were males and left sided obstruction wascommon. The most common diagnostic modality used was USG and excretory urography.CT urography was done in cases of secondary UPJO. DTPA scan was used in select casesfor baseline documentation of the function of the involved kidney. The average duration ofsurgery was 2 hours and 30 minutes. The mean duration of hospital stay was 5 days. The mostcommon complication was urinary tract infection.Conclusion: Open A-Hpyeloplasty is the most common surgery done for UPJO at ourinstitution. The outcome can be improved by attention to the principles of A-H pyeloplasty.