Cheng Yanxia,He Dawei,Liu Xing,Hua Yi,Zhang Deying,Liu Junhong,Liu Feng,Lin Tao,Wei Guanghui.Laparoscopic Anderson-Hynes pyeloplasty for ureteropelvic junction obstruction in infants[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(02):151-154.
Cheng Yanxia,He Dawei,Liu Xing,Hua Yi,Zhang Deying,Liu Junhong,Liu Feng,Lin Tao,Wei Guanghui.Laparoscopic Anderson-Hynes pyeloplasty for ureteropelvic junction obstruction in infants[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(02):151-154.DOI:
Laparoscopic Anderson-Hynes pyeloplasty for ureteropelvic junction obstruction in infants
efficacy and advantage of laparoscopic Anderson-Hynes pyeloplasty for the treatment of ureteropelvic junction (UPJ) obstruction in children younger than 1 year. Methods We retrospectively reviewe
d all infants who underwent transperitoneal laparoscopic Anderson-Hynes pyeloplasty for UPJ obstruction from July 2008 to May 2013 in our hospital (n=48). During operation all were drained randomly with double-J sent and ureteral sent as two groups of internal drainage and external drainage with simple random sampling. The operative duration
intraoperative and postoperative complications
postoperative hospital stay
and rate of pyeloplasty reoperation were compared between the two groups. We followed the change of anterior-posterior(AP) with ultrasound at regular intervals and analyzed the outcome of two groups after operation. Results Forty-seven infants completed transperitoneal laparoscopic Anderson-Hynes pyeloplasty except one case of intraoperative conversion to open surgery limited to abdominal working space because of intestine dilatation. Median operative time of two groups had no significant difference
82.8 min and 86.4 min
respectively (
P
0.05). No intraoperative complication about pneumoperitoneum and intestinal tract and other visceral organs was recorded in internal and external drainage groups. In two groups
eleven cases (23.4%) of post-operative complications were reported
of which seven (14.9%) belonged to Clavein Ⅰ and four (8.5%) belonged to Clavein Ⅱ. The seven Clavein Ⅰ cases contained 3 cases of anastomotic obstructions transiently and 1 case of drainage tube jam in the external drainage group
as well as 1 case of urinary extravasation 1 case of gross hematuria
and 1 case of incisional hernia of omentum cured after heteropathy treatment in the internal drainage group. The four Clavein Ⅱ cases were all found in the internal drainage group
with urinary tract infections accompanied by fever
and were cured after anti-infection treatment. The hospital stay of the external drainage group (10.6 d) was significantly longer than the internal drainage group (7.2 d) (
P
0.05). Median follow-up was 14 months (3 to 24 months). Statistical analysis demonstrated the outcome
of two groups had no difference. No case of reoperation was reported. Conclusion Laparoscopic Anderson-Hynes pyeloplasty is a safe
reliable and efficient procedure with an excellent outcome and minimal invasion for infants with UPJ obstruction. The operative way of ureteral sent is superior to the way of double-J sent.
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