Abstract
Background:
Modified Anderson-Hynes pyeloplasty is currently preferred for ureteropelvic junction obstruction (UPJO). Extravasation of urine and anastomotic stenosis are the most common complications after Anderson-Hynes pyeloplasty, which are closely linked with the technique for anastomosis. However, there are currently no clear guidelines for the suture bite depth in suturing the anastomosis during pyeloplasty.
Objective:
To analyze the optimal suture bite depth in laparoscopic Anderson-Hynes pyeloplasty.
Study Design:
A total of 90 children aged 4–14 years with UPJO-induced hydronephrosis who were surgically treated in the First People's Hospital of Lianyungang from July 2019 to July 2022 were prospectively recruited. All received laparoscopic Anderson-Hynes pyeloplasty using 5-0 Vicryl continuous sutures. According to the suture bite depth, the patients were divided into group A (depth 1 mm, n = 46) and group B (depth 0.5 mm, n = 44). Operation time, postoperative drainage volume, time of ureteral stent removal, incidence of postoperative complications, and time to hydronephrosis resolution were compared between groups.
Results:
Group A showed significantly less postoperative drainage volume, and shorter time of ureteral stent removal and hydronephrosis resolution (all P < .05). Four cases in group B received replacement of a double-J stent. Except for 1 patient receiving reoperation for anastomotic stenosis caused by massive extravasation of urine, the replaced double-J stent was successfully removed from the remaining 3 patients at 3 months, and the symptoms of anastomotic stenosis disappeared. No significant difference was detected in the operation time between groups (P > .05).
Conclusion:
An appropriate deeper suture bite depth for anastomosis may reduce postoperative urine extravasation and related complications in children who received laparoscopic pyeloplasty for UPJO-induced hydronephrosis.
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