Comparative study between ureter first approach and conventional open Anderson-Hynes pyeloplasty in paediatric patients: A prospective randomised study
Background: Uretero-pelvic junction obstruction is the most common form of congenital anomaly of the kidney and urinary tract with an incidence of about 1/1.000-1.500 of births and the aetiology and pathogenesis of this anomaly are still unclear until now. Methods: This is a prospective...
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PAGEPress Publications
2023-03-01
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| Series: | Archivio Italiano di Urologia e Andrologia |
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| Online Access: | https://www.pagepressjournals.org/index.php/aiua/article/view/11231 |
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| author | Basem A. Fathi Ahmed A. Elgammal Tamer A. Abouelgreed Osama M. Ghoneimy Abdrabuh M. Abdrabuh Mohamed A. Hindawy Ahmed Y. Aboelsaad Hazem Deif Alaa Mahmoud |
| author_facet | Basem A. Fathi Ahmed A. Elgammal Tamer A. Abouelgreed Osama M. Ghoneimy Abdrabuh M. Abdrabuh Mohamed A. Hindawy Ahmed Y. Aboelsaad Hazem Deif Alaa Mahmoud |
| author_sort | Basem A. Fathi |
| collection | DOAJ |
| description |
Background: Uretero-pelvic junction obstruction is the most common form of congenital anomaly of the kidney and urinary tract with an incidence of about 1/1.000-1.500 of births and the aetiology and pathogenesis of this anomaly are still unclear until now.
Methods: This is a prospective randomized comparative study conducted from March 2022 to December 2022. Thirty children with uretero-pelvic junction obstruction were included and randomly divided into two groups according to a 1:1 ratio (computer-generated randomization, single blind). Fifteen cases (12 males and 3 female) were subjected to ureter first approach pyeloplasty, and another fifteen (9 males and 6 female) were subjected to conventional Anderson Hynes pyeloplasty.
Results: The mean age of all patients was 6.7 ± 5.4 years in ureter first approach group and 5.1 ± 4.3 years in conventional Anderson-Hynes pyeloplasty group. There were no significant differences between the two groups regarding age, gender, presentation, side, preoperative renogram and post-operative renogram. Also, there were no significant differences between the two groups regarding operative time (in first group 110.3 ± 12.4 and in the second group 111.2 ± 12.0 with p < 0.836), pre and post-operative complication rate. Two cases of urinary tract infections in the first group, one of them having fever, and four cases in the second group, two of them having fever (p < 0.651); four cases of loin pain in the first group and one case in the second group (p < 0.330); one case in the first group having pro- longed leakage of urine for 7 days in post-operative period (p < 0.309). However GFR and t 1⁄2 improved significantly after operation in both groups (p < 0.001).
Conclusions: Ureter first approach is a simple and effective procedure in children with good short term outcomes and could be done safely especially for beginners and less expert surgeons. Finally, it can overcome the problem of long ureteric stricture that may be found intraoperatively because you can shift easily to a flap procedure and complete a tension free anastomosis.
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| first_indexed | 2024-04-09T23:20:34Z |
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| language | English |
| last_indexed | 2024-04-09T23:20:34Z |
| publishDate | 2023-03-01 |
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| spelling | doaj.art-488452f78cf346b3a89804016315c2262023-03-21T22:44:58ZengPAGEPress PublicationsArchivio Italiano di Urologia e Andrologia1124-35622282-41972023-03-0195110.4081/aiua.2023.11231Comparative study between ureter first approach and conventional open Anderson-Hynes pyeloplasty in paediatric patients: A prospective randomised studyBasem A. Fathi0Ahmed A. Elgammal 1Tamer A. Abouelgreed2Osama M. Ghoneimy3Abdrabuh M. Abdrabuh4Mohamed A. Hindawy5Ahmed Y. Aboelsaad6Hazem Deif7Alaa Mahmoud8Department of Urology, Faculty of Medicine, Al-Azhar University, CairoDepartment of Urology, Faculty of Medicine, Al-Azhar University, CairoDepartment of Urology, Faculty of Medicine, Al-Azhar University, CairoDepartment of Urology, Faculty of Medicine, Al-Azhar University, CairoDepartment of Urology, Faculty of Medicine, Al-Azhar University, CairoDepartment of Urology, Faculty of Medicine, Al-Azhar University, CairoDepartment of Urology, Faculty of Medicine, Al-Azhar University, CairoDepartment of Urology, Faculty of Medicine, Al-Azhar University, CairoDepartment of Urology, Faculty of Medicine, Al-Azhar University, Cairo Background: Uretero-pelvic junction obstruction is the most common form of congenital anomaly of the kidney and urinary tract with an incidence of about 1/1.000-1.500 of births and the aetiology and pathogenesis of this anomaly are still unclear until now. Methods: This is a prospective randomized comparative study conducted from March 2022 to December 2022. Thirty children with uretero-pelvic junction obstruction were included and randomly divided into two groups according to a 1:1 ratio (computer-generated randomization, single blind). Fifteen cases (12 males and 3 female) were subjected to ureter first approach pyeloplasty, and another fifteen (9 males and 6 female) were subjected to conventional Anderson Hynes pyeloplasty. Results: The mean age of all patients was 6.7 ± 5.4 years in ureter first approach group and 5.1 ± 4.3 years in conventional Anderson-Hynes pyeloplasty group. There were no significant differences between the two groups regarding age, gender, presentation, side, preoperative renogram and post-operative renogram. Also, there were no significant differences between the two groups regarding operative time (in first group 110.3 ± 12.4 and in the second group 111.2 ± 12.0 with p < 0.836), pre and post-operative complication rate. Two cases of urinary tract infections in the first group, one of them having fever, and four cases in the second group, two of them having fever (p < 0.651); four cases of loin pain in the first group and one case in the second group (p < 0.330); one case in the first group having pro- longed leakage of urine for 7 days in post-operative period (p < 0.309). However GFR and t 1⁄2 improved significantly after operation in both groups (p < 0.001). Conclusions: Ureter first approach is a simple and effective procedure in children with good short term outcomes and could be done safely especially for beginners and less expert surgeons. Finally, it can overcome the problem of long ureteric stricture that may be found intraoperatively because you can shift easily to a flap procedure and complete a tension free anastomosis. https://www.pagepressjournals.org/index.php/aiua/article/view/11231HydronephrosisPyeloplastyUreter first |
| spellingShingle | Basem A. Fathi Ahmed A. Elgammal Tamer A. Abouelgreed Osama M. Ghoneimy Abdrabuh M. Abdrabuh Mohamed A. Hindawy Ahmed Y. Aboelsaad Hazem Deif Alaa Mahmoud Comparative study between ureter first approach and conventional open Anderson-Hynes pyeloplasty in paediatric patients: A prospective randomised study Archivio Italiano di Urologia e Andrologia Hydronephrosis Pyeloplasty Ureter first |
| title | Comparative study between ureter first approach and conventional open Anderson-Hynes pyeloplasty in paediatric patients: A prospective randomised study |
| title_full | Comparative study between ureter first approach and conventional open Anderson-Hynes pyeloplasty in paediatric patients: A prospective randomised study |
| title_fullStr | Comparative study between ureter first approach and conventional open Anderson-Hynes pyeloplasty in paediatric patients: A prospective randomised study |
| title_full_unstemmed | Comparative study between ureter first approach and conventional open Anderson-Hynes pyeloplasty in paediatric patients: A prospective randomised study |
| title_short | Comparative study between ureter first approach and conventional open Anderson-Hynes pyeloplasty in paediatric patients: A prospective randomised study |
| title_sort | comparative study between ureter first approach and conventional open anderson hynes pyeloplasty in paediatric patients a prospective randomised study |
| topic | Hydronephrosis Pyeloplasty Ureter first |
| url | https://www.pagepressjournals.org/index.php/aiua/article/view/11231 |
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