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Pyeloplasty in infancy

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Abstract

Objective : The advent of routine maternal ultrasound has increased the number of neonates diagnosed to have ureteropelvic junction obstruction. Though the debate concerning its ideal management continues, recent years have witnessed reports on pyeloplasty in infancy. This study presents the feasibility and outcome of pyeloplasty in neonates and infants from a single centre.Methods : The authors examined the records of 40 neonates and infants (46 renal units) who underwent pyeloplasty for ureteropelvic junction obstruction since 1988. Patient characteristics, clinical presentation, investigations, associated anomalies, age at surgery, operative technique and outcome were evaluated.Result : The mean and median age at surgery was 3.5 and 2.5 months respectively, and mean postoperative hospital stay six days. Associated anomalies were found in 27% of infants and in some they influenced the outcome. In 72%, no stent or nephrostomy was used. However, all had a closed perinephric drain. There was no mortality in this series. Complications (8.7%) comprised anastomotic leak in three and anastomotic stricture in one unit. In 35 of 38 renal units, improved drainage and recovery of differential function was confirmed on postoperative renogram.Conclusion : Where indicated, pyeloplasty in the neonate and infant will be readily adopted by specialists for the select few it would benefit. It is hoped that all those involved in the care of these infants will take cognisance of this fact to ensure early optimal management of ureteropelvic junction obstruction.

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Author notes

  1. Ashley J D’Cruz (Professor and Head)

    Present address: Department of Pediatric Surgery, St. John’s Medical College Hospital, St. John’s National Academy of Health Sciences, 560 034, Bangalore, India

Authors and Affiliations

  1. Department of Pediatric Surgery, St. John’s Medical College Hospital, St. John’s National Academy of Health Sciences, 560 034, Bangalore, India

    Kanishka Das

Authors
  1. Kanishka Das
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  2. Ashley J D’Cruz
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Das, K., D’Cruz, A.J. Pyeloplasty in infancy. Indian J Pediatr 70, 379–382 (2003). https://doi.org/10.1007/BF02723609

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