Anderson-Hynes Pyeloplasty for Pelviureteric Junction Obstruction in Infant

Abstract

Background: Pelviureteric junction obstruction(PUJO) is the commonest cause of antenatal hydronephrosis. Majority of antenatal hydronephrosis resolve with watchful observation in postnatal period. Amongst them, very few will require intervention in infancy. Anderson- Hynes pyeloplasty is considered as standard procedure for PUJO. This study aimed toevaluate and assess the outcome of this procedure in an infant with severe hydronephrosis secondary to PUJO. Methods: A retrospective review of all infants with moderate to severe hydronephrosis due to PUJO who underwent Anderson-Hynes Pyeloplasty between Baisakh 2079 to Chaitra 2080 (2 years) was evaluated. Different demographic data including age and sex of patient, side of surgery, ultrasound grading of hydronephrosis, total operative time, their hospital stay, outcome and complications were assessed. Results: Total 26 infants (17 boys and 9 girls) with PUJO underwent Anderson-Hynes Pyeloplasty with a mean age of 6.35 months (1 month to 11 months). 87.8 minutes was the mean operative time period. 3.75 days (3 days to 5 days) was mean hospital stay.Major complications include anastomotic stricture in one infant and one case had recurrent UTI. Postoperative ultrasound and DTPA scan were obtained after 6 months postoperatively, which showed improved renal function in DTPA in 24 patients (92.4%). Conclusion: Anderson-Hynes Pyeloplasty is the gold standard procedure in PUJO. Its implication in infant age group is also safe. For better outcome, patient selection and refinement technique should be pursued.