Nondismembered side-to-side pyeloureterostomy for uretropelvic junction obstruction in children: Preliminary results

Ali, Omar Khaled Ahmed; El Asmar, Khaled M.; Dahab, Mohamed M.; Soliman, Mohamed H.; Shokry, Shady S.; Zaki, Amr A.; Abdelhamid, Sameh A.

doi:10.4103/ejs.ejs_179_22

Nondismembered side-to-side pyeloureterostomy for uretropelvic junction obstruction in children: Preliminary results

Authors

Abstract

Background
Anderson-Hynes pyeloplasty is considered preferable to nondismembered pyeloplasty either open or laparoscopic owing to its versatility and the funnel-shaped-dependent anastomosis done. The anastomosis during laparoscopic Anderson-Hynes pyeloplasty is technically demanding because it necessitates considerable skill in intracorporeal suturing with the risk of ureteral twisting. In an attempt to make the operation easier and less time consuming, some authors turned back to nondismembered procedures, reporting good therapeutic results.
Aim
The aim of our study was to assess the initial results of a nondismembered pyeloplasty in cases of ureteropelvic junction obstruction (UPJO) with dilated extrarenal pelvis either by open surgical or laparoscopic techniques with recording of any intraoperative difficulties or postoperative complications.
Patients and methods
This is a clinical trial conducted at Ain Shams University hospitals including patients with UPJO with dilated extrarenal pelvis who underwent open and laparoscopic pyeloplasty using side-to-side pyeloureteric anastomosis without reduction of renal pelvis in the period from March 2020 till March 2022.
Results
Overall, five patients were included in this study, where three of them were operated by open approach and two by laparoscopic approach. All of them showed marked reduction in renal pelvis antroposterior diameter, with improvement of differential function of the affected kidney on renal isotope scan in a follow-up period of 6 months to 1 year.
Conclusion
Nondismembered side-to-side pyeloplasty is a feasible technique for UPJO with dilated extrarenal pelvis, which has shown successful preliminary results in open and laparoscopic approaches.

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