WOFAPS 2025 8th World Congress of Pediatric Surgery

Suman Bikram Adhikari ¹, Surendra Bikram Adhikari ², Bal Mukunda Basnet ¹

¹ Kanti Children's Hospital, Maharajgunj, Kathmandu
² Grande International Hospital, Kathmandu

Introduction: Pelviureteric junction obstruction (PUJO) is the commonest cause of antenatal hydronephrosis. Majority of antenatal hydronpehrosis resolve with watchful observation in postnatal period. Amongst them, very few will require intervention in infancy. Anderson- hynes pyeloplasty is the gold standard procedure for pelviureteric junction obstruction. The objective of this study was to evaluate and assess the outcome of Anderson-Hynes Pyeloplasty in infant with severe hydronephrosis secondary to PUJO.

Methods: A retrospective review of all infants with severe hydronpehrosis due to PUJO who underwent Anderson-Hynes Pyeloplasty between March 2022 to April 2024 (2 years) was done. The following were recorded for each patient: age, sex, grading of hydronpehrosis, operative time, hospital stay, outcome and complications.

Results: This study consisted of 26 infants (17 boys and 9 girls) who underwent Anderson-Hynes Pyeloplasty with a mean age of 6.3 months (1 month to 11 months). All infants had severe hydronephrosis (Grade 4). Right side repair was performed in 19 patients (73%). Mean operative time was 87.8 minutes. The mean length of hospital was 3.75 days (3- 5 days). Major complications include anastomotic stricture in one infant and one case had recurrent UTI. Postoperative ultrasound and DTPA scan was obtained after 6 months postoperatively, which showed improved renal function in DTPA in 24 patients (92.4%).

Conclusion: Anderson-Hynes Pyeloplasty is 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.