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W-type suture in Anderson-Hynes laparoscopic pyeloplasty: a novel approach to an old technique
Dawid Janczak1, Urszula Szydełko2, Wojciech Apoznański3
1Department of Urology, 4 Military Hospital, Wroclaw, Poland.
Introduction:
Anderson-Hynes (A-H) dismembered pyeloplasty has remained nearly unchanged since its introduction in 1949. The authors present a modification of the uretero-pelvic anastomosis as described by Anderson and Hynes. The new approach, called the W-type suture, is thought to be more watertight and associated with fewer complications than the original.
Aim:
To assess the effectiveness of the modification of Anderson-Hynes dismembered pyeloplasty named the W-type suture.
Material And Methods:
The research is a retrospective study of 99 patients who underwent laparoscopic A-H pyeloplasty. In 49 patients unmodified laparoscopic A-H pyeloplasty was carried out. Fifty patients underwent laparoscopic A-H pyeloplasty with the anastomosis made using the aforementioned W-type suture. To assess the effectiveness of the W-type suture, we compared urine leakage duration - a direct indicator of anastomosis tightness - and frequency of postoperative complications.
Results:
The mean duration of urinary leakage was 3 ±1.16 days for the W-type suture anastomosis group and 3.57 ±1.14 days for the unmodified A-H pyeloplasty group (p < 0.05). The frequency of post-operative complications did not statistically significantly differ between the groups except for fever (18.4% vs. 4%; p < 0.05).
Conclusions:
The analysis of the collected data showed that the W-type suture might be a promising alternative to a traditional approach of performing the ureteropelvic anastomosis. Further research should be done to minimize biases present in this study, which might have influenced our results.
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