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pyeloplasty According to Küss-Anderson-Hynes: Results and Complications at the Urology-Andrology Department of the Sino-Guinean Friendship Hospital

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Open Journal of Urology 2022年第9期12卷 471-477页

作者： Alimou Diallo Thierno Mamaou Oury Diallo Thierno Oumar Diallo Demba Cissé Sory Naby Camara Alpha Oumar Barry Mamadou Barry Ibrahima Bah Abdoulaye Bobo Diallo Oumar Raphiou Bah Department of Urology Sino-Guinean Friendship Hospital Faculty of Health Sciences and Technologies Gamal Abdel Nasser University of Conakry Conakry Guinea National Ignace Deen Hospital Faculty of Health Sciences and Technologies Gamal Abdel Nasser University of Conakry Conakry Guinea National Ignace Deen Hospital Faculty of Health Sciences and Technologies Gamal Abdel Nasser University of Conakry Conakry Guinea Department of Urology Kolda Regional Hospital Cheick Anta Diop University Dakar Senegal

Objective: Evaluate pyeloplasty according to Küss-Anderson-Hynes at the urology-andrology department of the Sino-Guinean Friendship Hospital. Patient and Method: This is a 3-year prospective descriptive study from January 1, 2018 to December 31, 2020. It focused on a sample of 21 patients, who had undergone pyeloplasty according to Küss-Anderson-Hynes. Results: The averages age of the patients was 24.24 years. Lumbar pain was the main reason for consultation in 71.43% of cases. pyeloplasty according to Küss-Anderson-Hynes alone was performed in 76.20% of cases. It was associated with lower pole vessel uncrossing in 14.29% of cases and in 9.52% of cases with pyelolithotomy. The main Postoperative complications consisted of surgical site infections (23.81%) and fistula of the pyelo-ureteral junction (9.52%). The result of the pyeloplasty evaluated after three years, was qualified as good in 13 patients (86.67%), conversely the result was declared bad in 2 patients or 13.33%. During the follow-up period, postoperatively, we had lost sight of 6 patients. Conclusion: pyeloplasty according to Küss-Anderson-Hynes in addition to its excellent results reported by the literature was the only therapeutic alternative performed during this study. However, its indications are considerably reduced with the advancement of laparoscopy.

关键词： pyeloplasty Küss-Anderson-Hynes Parietal Suppuration

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Small incision combined with laparoscopy for ureteropelvic junction obstruction： comparison with retroperitoneal laparoscopic pyeloplasty

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Chinese Medical Journal 2009年第22期122卷 2728-2732页

作者： WU Ji-tao GAO Zhen-li SHI Lei HAN Bang-min MEN Chang-ping ZHANG Peng XIA Shu-jie Department of Urology First People's Hospital Affiliated to Shanghai Jiao Tong University Shanghai 200080 China Department of Urology Yantai Yuhuangding Hospital Yantai Shandong 264000 China

Background Laparoscopic dismembered pyeloplasty is technically feasible for ureteropelvic junction （UP J） obstruction although it is still challenged by its technical difficulty and time-consuming. In this study, we compared the initial results of retroperitoneal laparoscopic pyeloplasty versus a combined laparoscopic dissection and open reconstruction through a small incision in the treatment of UPJ obstruction.Methods Sixty-four patients with primary UPJ obstruction underwent pyeloplasty： 32 patients underwent laparoscopic procedure and 32 patients underwent open assisted laparoscopic surgery including two steps, ie, laparoscopic dissection of the UPJ transperitoneally and then pyeloplasty via an extended small incision. The demographic data and intraoDerative, postoperative and follow-up conditions of patients were compared between the two groups.Results Preoperative data were comparable in the patients of the two groups. The operative time was shorter （60.9 minutes vs 157.7 minutes, P 〈0.0001） and the complication rate was lower （9.4% vs 31.3%, P 〈0,05） in the open assisted group than in the laparoscopic group. The estimated blood loss （42.3 ml vs 47.8 ml）, time to have normal diet （37.6 hours vs 33.8 hours）, and hospital stay （6.7 days vs 6.2 days） were equivalent, The operative success rate was 97% for the open assisted group and 91% for the laparoscopic group. Conclusions The procedure of combined small incision with laparoscopy for UPJ obstruction is technically easy, and the results are promising. It can be used as an alternative to conventional procedures.

关键词： laparoscopy ureteropelvic junction obstruction minimally-invasive surgery pyeloplasty

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Experience with transperitoneal laparoscopic dismembered pyeloplasty

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Chinese Medical Journal 2005年第3期118卷 246-248页

作者： ZHANGDa-hong YUDa-min DINGGuo-qing CHENYue-bing LIXin-de DepartmentofUrology ShaoyifuHospitalZhejiangUniversityMedicalCollegeHangzhou310016China

pyeloplasty is a standard therapy for ureteropelvic junction obstruction witha success rate of over 90% for all types of repair. In 1993 the first cases of laparoscopic repairof ureteropelvic junction obstruction via the transperitoneal approach were described. In the lastfew decades open pyeloplasty has been a standard for surgical treatment with a long-term successrate of more than 90%. The results have shown the feasibility of Anderson-Hynes dismemberedpyeloplasty. In this report, we present our experience with transperitoneal laparoscopicdismembered pyeloplasty in 18 patients with ureteropelvic junction obstruction ( UP JO ) at ourhospital between October 2001 and October 2002. All the operations were successful and the resultssatisfactory.

关键词： pyeloplasty ureteropelvic junction obstruction transperitoneal approach

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Laparoscopic Transperitoneal pyeloplasty for Ureteropelvic Junction Obstruction: Preliminary Results from 26 Cases

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Surgical Science 2023年第5期14卷 309-320页

作者： Cyril Kamadjou Divine Enoru Eyongeta Annie Kameni Wadeu Patrick Fotso Gwabap Bertin Njinou Ngninkeu Edouard Hervé Moby Medico Surgical Centre of Urology and Mini Invasive Surgery Douala Cameroon Department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Surgery Faculty of Health and Sciences University of Buea Buea Cameroon Clinic of Aeroport Douala Cameroon

Background and Objectives: Pyelo-Ureteral Junction Syndrome (PUJS) is the most common obstructive malformation of the upper urinary tract in children and adults. The standard treatment is open pyeloplasty using the Kuss-Anderson technique. Because of the minimally invasive nature of the laparoscopic approach, it has become the approach of choice for the management of this pathology. We present the results of laparoscopic transperitoneal pyeloplasty used in the management of PUJS. Materials and Methods: This was a retrospective study from 2015 to 2020, including 26 patients who underwent laparoscopic transperitoneal pyeloplasty for PUJS. Results: Twenty-six patients, including 18 (69.2%) men and 6 (30.8%) women, with a mean age of 35.42 ± 13.62 years, were treated. Renal colic was the primary symptom in the majority of the cases (22, 84.6%)). The diagnosis was confirmed in all patients through an abdominal CT scan, which revealed that all 26 patients had hydronephrosis. Half of the patients (50.0%) were classified as Valayer-Cendron Type II, and eight (30.8%) patients had associated stones. Seventeen (65.4%) patients had pathologies on the left side, and all patients were treated using the Kuss-Anderson technique with a median operating time of 108.5 (90.0 - 136.0) minutes. The uncrossing of lower pole vessels was performed in 10 patients. The average duration of hospitalisation was 2.23 ± 0.82 days. No conversion was observed, and after an average follow-up of 53.69 days, the success rate was 92.3%. Conclusion: Laparoscopic pyeloplasty is a minimally invasive technique of choice for the treatment of pyelo-ureteral junction obstruction. It is dependable, repeatable, and produces good functional outcomes that are equal to those of traditional surgery.

关键词： Pyelo-Ureteral Junction Lower Pole Vessel pyeloplasty Double J Stent

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Anderson-Hines Open pyeloplasty in the Treatment of Pyelo-Ureteral Junction Syndrome: Results from 36 Cases

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Open Journal of Urology 2019年第9期9卷 131-139页

作者： Anani Wencesl Severin Odzébé Caryne Mboutol-Mandavo Aristide Steve Ondziel Opara Lucie Irene Patricia Ondima Armel Melvin Ondongo Atipo Rolland Bertile Banga Mouss Prosper Alain Bouya Department of Urology and Andrology University Hospital Brazzaville Congo Department of Padiatric Surgery Faculty of Health Science University Marien Ngouabi Brazzaville Congo

Goal: To evaluate the results and complications of open pyeloplasty according to Anderson-Hynestechnic. Patients and Methods: We conducted a retrospective study from 2000 to 2014. The study included 36 cases of opening the ureteropyelic junction operated pit syndrome according to Anderson-Hynes technique. Results: Lumbotomy was used in all patients. A pelvic pyelolithotomy for lithiasis was performed in two patients (5.5%) and unwinding of a lower polar pedicle in 3 cases (8.3%). The average duration of response was 119 ± 15 min. The average length of hospital stay was 11.2 ± 3 days. Patients were followed for a mean of 10 months. Thirty-five patients were asymptomatic and in one case lower back pain persisted. IVU to 6 months showed a permeable junction in 97.2% of cases. Seven patients (19.4%) had short-term complications. Ureteropelvic stenosis was the only complication in the medium and long term in one case (2.8%). The success rate of the pyeloplasty was 97.2%. Conclusion: The open pyeloplasty as Anderson-Hynes remains the treatment of choice in our context SJPU with great results. The indications tend to decrease in favor of laparoscopic pyeloplasty.

关键词： Hydronephrosis pyeloplasty Anderson Hynes Open Surgery

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Interventional Radiology Procedures after Pediatric pyeloplasty and Ureteral Reimplantation in Patients with Postoperative Obstruction

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Open Journal of Urology 2014年第6期4卷 87-90页

作者： Brent W. Snow M. Chad Wallis G. Peter Feola John W. Rampton Teisha Shiozaki Division of Pediatric Urology University of Utah School of Medicine Salt Lake City USA Primary Children’s Medical Center Salt Lake City USA

Introduction: Obstructive complication after pyeloplasty or ureteral reimplant surgery is a rare though worrisome problem in pediatric urology. These are often complex patients with complicated post-operative courses that at times require interventional radiology procedures. The current literature is lacking in guiding principles to manage these complications. In this study we have reviewed these difficult to manage patients at our children’s hospital over the past 15 years. Methods: A list of patients who underwent interventional radiology procedures to place nephrostomy tubes or internal double-J ureteral stents was compared a list of patients undergoing pyeloplasty or reimplant procedures. These lists were cross-referenced to a list of patients undergoing cystoscopic removal of double-J stents. This small patient group does not represent all complications but those with radiology intervention. Results: At our institution, during the years 1998-2011 we performed 458 pyeloplasties and 3003 open ureteral reimplant procedures. 14 (0.4%) met all of the inclusion criteria. The long term outcome of these problems showed 11 of these patients went on to stability or improvement with either percutaneous drainage or JJ stent placement alone, and three of the reimplant patients ultimately required redo surgery. Of our pyeloplasty patients only three required percutaneous nephrostomy tube, and one went on to JJ stent placement (0.66% of pyeloplasties). No patients in the pyeloplasty group needed surgical revision. Of patients how had undergone ureteral reimplantation, with or without tapering, seven of them underwent interventional radiology procedures (0.23% of reimplant patients). Conclusion: Pediatric urology patients with persistent obstruction after pyeloplasties and ureteral reimplantation surgery with or without tapering who needed interventional radiology rescue procedure resolved or stabilized in 11 of 14 patients. Surgical revision was performed in only 3 of our 14 patients after months of conservative trial afte

关键词： Interventional Radiology Pediatrics Ureteral Reimplantation pyeloplasty Postoperative Obstruction

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Round-Traction-Assisted pyeloplasty (Ro.T.A.P.): A Minimal Approach Using Alexis<sup>®</sup>Autostatic Retractor

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Open Journal of Urology 2015年第10期5卷 192-198页

作者： Vincenzo Domenichelli Maria Domenica Sabatino Simona Straziuso Francesco Italiano Silvana Federici Pediatric Surgical Unit “Infermi” Hospital AUSL Romagna Rimini Italy In charge of Pediatric Urology Unit “Infermi” Hospital AUSL Romagna Rimini Italy

Anderson-Hynes dismembered ureteropyeloplasty has been the gold standard surgical treatment for ureteropelvic junction obstruction (UPJO) caused either by crossing renal vessel or by a stenotic junction in children. Nowadays it is still discussed which could be the best surgical approach. All the techniques actually used have the goal to improve functional outcome and to reach better results in terms of reducing traumatic damage, postoperative pain and therefore reduction of hospitalization. We are presenting our experience in the treatment of UPJO by open dismembered pyeloplasty with a minimal invasive approach using the Alexis®(Applied Medical, Rancho Santa Margherita, CA) autostatic wound retractor.

关键词： pyeloplasty Anderson-Hynes Alexis Minimally Invasive Surgery UJPO

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Retrospective comparison of retroperitoneal laparoscopic versus open dismembered pyeloplasty for ureteropelvic junction obstruction

Retrospective comparison of retroperitoneal laparoscopic ver...

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第十三届全国泌尿外科学术会议暨第八届全球华人泌尿外科学...

作者： Zhang Xu Li Hong-Zhao Ma Xin Zhang Jun Lang Bin Fu Bin Xu Kai Zheng Tao Wang Bao-Jun Ju Zheng-Hua and Shi Tao-Ping From the Department of Urology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430030 People’s Republic of China

＜正＞Purpose: To evaluate the clinical value of retroperitoneal laparoscopic dismembered pyeloplasty for ureteropelvic junction obstruction as compared with open surgery. Materials and Methods: The clinical data of 5... 详细信息

关键词： laparoscopy pyeloplasty kidney

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产前诊断并早期手术对小儿肾积水预后的影响

产前诊断并早期手术对小儿肾积水预后的影响

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作者：周蔚广西医科大学

学位级别：硕士

目的:通过回顾性分析85例小儿肾盂输尿管交界处狭窄患儿的诊断和治疗,旨在探讨产前诊断并积极随访,产后早期手术治疗对本病预后的影响,从而进一步改善肾盂输尿管交界处梗阻致肾积水患儿的预后。方法:将85例肾盂输尿管交界处狭窄患儿按... 详细信息

目的:通过回顾性分析85例小儿肾盂输尿管交界处狭窄患儿的诊断和治疗,旨在探讨产前诊断并积极随访,产后早期手术治疗对本病预后的影响,从而进一步改善肾盂输尿管交界处梗阻致肾积水患儿的预后。方法:将85例肾盂输尿管交界处狭窄患儿按其是否行产前诊断分为产前组和产后组。对两组患儿术前病情、术中所见大体病理及采用术式、出院前恢复状况及并发症发生率等多项预后参数进行收集,并行统计学分析后得出结论。所用统计学方法均选用两样本率的比较,及卡方检验,P<0.05有统计学意义。统计软件选用SPSS13.0。结果:产前组在术前肾积水四级以上、继发肾结石、对侧肾积水、术前合并感染等病情程度参数及肾周粘连、术后并发症发生率等指标上均低于产后组(P<0.05),差别有显著性意义。术后多联抗生素使用率高于产后组(P<0.016),差别有显著性意义。在术前肾造瘘、术中所见脓肾、术后三线抗生率使用、术后带管出院等参数上,两样本率的比较存在微弱差异,经卡方检验无显著性意义。在术中选择肾切除术上,两样本率的比较和卡方检验均无明显差别,无统计学意义。结论:1.肾积水病变是进行性的,肾实质的损害与积水程度和时间呈正相关。2.产前及产后超声检查和随访是非常必要的,且有利于临床医生早期检测并判断病情。3.在完善术前准备和有效抗炎治疗的条件下,早期手术是安全可靠的,且在术后初期可达与大龄儿童相同临床治愈效果。4.产后早期手术治疗在有效防范先天性肾积水患儿发生严重并发症及不可逆肾脏改变上更有临床意义。

关键词： prenatal diagnosis hydronephrosis ureteropelvic junction obstruction pyeloplasty prognosis

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