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[The surgical treatment of congenital hydronephrosis in children]
Insights
Surgical treatment for pediatric hydronephrosis using the Andersen-Hynes operation showed a 12% rate of anastomotic stenosis. Modifications to the technique, including microsurgical instruments and synthetic sutures, improved outcomes in subsequent cases.
Area of Science:
- Pediatric Surgery
- Urology
Context:
- Hydronephrosis affects children, often requiring surgical intervention.
- The Andersen-Hynes operation and its modifications are used to treat pediatric hydronephrosis.
Purpose:
- To evaluate the results of surgical treatment for pediatric hydronephrosis.
- To identify causes of anastomotic stenosis and propose technique modifications.
Summary:
- The study reviewed 85 children (6 months-14 years) treated for hydronephrosis via the Andersen-Hynes operation (1981-1987).
- Anastomotic stenosis occurred in 12% of cases due to factors like trauma, suture material, and inadequate drainage.
- Modified techniques involved restricted surgical manipulation, optical amplification, microsurgical instruments, synthetic sutures, and a novel silicon rubber pyelostoma for drainage.
Impact:
- Modified surgical techniques and improved drainage methods led to good or satisfactory results in all 34 reviewed surgical cases with no recorded complications.
Abstract:
Available are the results of surgical treatment (Andersen-Hynes operation and its modifications) of 85 children with hydronephrosis bor the period 1981-1987. The patients' age ranged from 6 months to 14 years. Anastomotic stenosis occurred in 12% of the procedures as a result of: urethral or pelvic trauma when suturing, wound channels due to the needle perforating puncture, catgut unwanted properties, tissue strain at the anastomosis site, inadequate renal drain. This necessitates modification of the operative technique: surgical manipulations restricted to the operated on pelvic part and pelvic-urethral segment, optical amplification, microsurgical instruments, synthetic suture. An original pyelostoma made of silicon rubber was used in draining. Out of 34 surgical cases, good results were achieved in 31, satisfactory in 3. No complications were recorded.