Publication: Open Anderson Hynes Pyeloplasty in Ureteropelvic Junction Obstruction: An Institutional Experience
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Date
2015
Journal Title
Journal ISSN
Volume Title
Publisher
Institute of Medicine
Abstract
Abstract
Introduction: Ureteropelvic junction obstruction (UPJO) is one of the common causes of hydronephros is in children and adults. The cause may be congenital or acquired. The standard management of UPJO has classically been an open Anderson-Hynes (A-H) dismembered pyeloplasty. This study is an audit of A-H pyeloplasty done for patients with UPJO presenting to our institution.
Methods: A retrospective analysis was done in the Urology unit, Tribhuvan University Teaching Hospital from July 2013 to November 2014. All patients undergoing A-H pyeloplasty were included for review. Preoperative data regarding the demographics, presentation, diagnostic tools used, details of the surgery, postoperative complications, duration of hospital stay 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 assess the function and clearance of the treated kidney.
Results: The age of the patients ranged from 5 months to 69 years. Flank pain was the most common presenting complain. Most of the patients were males and left sided obstruction was common. 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 cases for baseline documentation of the function of the involved kidney. The average duration of surgery was 2 hours and 30 minutes. The mean duration of hospital stay was 5 days. The most common complication was urinary tract infection.
Conclusion: Open A-Hpyeloplasty is the most common surgery done for UPJO at our institution. The outcome can be improved by attention to the principles of A-H pyeloplasty.
Keywords: hydronephrosis, A-H pyeloplasty, ureteropelvic junction obstruction
Description
PP Subedi
MCh Resident, Tribhuvan University Teaching Hospital, Maharajgunj, Nepal
S Chapagain
MCh Resident, Tribhuvan University Teaching Hospital, Maharajgunj, Nepal
DK Thakur
MCh Resident, Tribhuvan University Teaching Hospital, Maharajgunj, Nepal
S Poudyal
MCh Resident, Tribhuvan University Teaching Hospital, Maharajgunj, Nepal
BR Luitel
Assistant Professor,Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal.
PR Chalise
Assistant Professor,Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal.
UK Sharma
Assistant Professor,Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal.
PR Gyawali
Professor,Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
GK Shrestha
Professor,Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
Keywords
hydronephrosis, A-H pyeloplasty, ureteropelvic junction obstruction