Seguimiento de pacientes llevados a pieloplastia abierta experiencia multiinstitucional durante 6 años

Introduction and Objectives: Ureteropelvic junction obstruction (UPJO) is the most common cause of pathological prenatal hydronephrosis. Ultrasound (US) has changed the diagnosis and management of this condition. The most common surgical approach is the Anderson-Hynes pyeloplasty technique. The purpose of the present study is to describe our experience with this technique over the last 6 years and to evaluate the advantages and disadvantages. Methods y Materials: A record was made of every patient who was operated at the Hospital San Ignacio, Hospital Militar Central, and Fundación Santa Fe de Bogotá since january 2006. Data was collected until April 2012. Information was recorded at the time of the procedure and in every follow-up visit afterwards. Analyzed variables were: age at surgery, details about diagnosis, surgery, and postoperative care. Results: During the study period, 57 patients underwent a pyeloplasty. The mean age at surgery was 59 months. Antenatal diagnosis of the hydronephrosis was made in 70% of the cases. All procedures were the Anderson-Hynes technique. No case was bilateral. The drain was removed, on average, on the fourth postoperative day and the double J stent at 6 weeks. All cases showed some improvement or resolution of the hydronephrosis. Of the total of patients, 44 had a double J catheter placed at surgery. In 14 (24%) patients a complication was detected, and almost all occurred during the first three months after surgery. The most common complication was postoperative urinary tract infection in 9 (15.7%) patients. On average, these patients had their double J stents for 7.3 weeks. Conclusions: Anderson-Hynes is very successful for resolving the obstruction of the urinary tract. The presence of postoperative UTI as the main complication questions the possibility of the timing of double J stent use and for how long.