The Comparison Of Two Urine Drainage Methods After Anderson-Hynes Pyeloplasty

Background Congenital hydronephrosis is a common disease in children with urology.And the incidence of newborns accounted for 1% to 2%.Prenatal ultrasound showed hydronephrosis.In general,the fetal genitourinary system will gradually mature with the increase of the pregnant cycle.Some newborns mild hydronephrosis may self-subsided,and the renal function will improved.However,if some patients with moderate or severe hydronephrosis fail to receive timely diagnosis and treatment,they may lead to kidney damage and renal failure in severe cases[1?2].Therefore,children with hydronephrosis should be followed up regularly and timely surgery,so as not to delay the patient's illness.The principle of surgical treatment for congenital hydronephrosis in children is Anderson-Hynes pyeloplasty.Through surgical resection the causes of affected hydronephrosis,and then achieved the purpose of alleviating hydronephrosis in children.After surgical,as common,the drainage tube can be used to drain urine,to avoid the occurrence of ureteral stricture to the possibility of hydronephrosis.At present,there are two methods of internal drainage and external drainage.In this paper,the advantages and disadvantages of the two drainage methods were analyzed by comparing the operation and hospitalization time,the amount of blood loss,complications and postoperative follow-up of the two drainage methods after hydronephrosis.Objective To explore the advantages and disadvantages of double J tube drainage and external drainage in the application of hydronephrosis after hydronephrosis.Methods Collect 62 cases in our hospital patients with hydronephrosis from January 2013 to January 2016.With 50 men and 12 women,age range 1month-12years(mean 2.54 years),with a total of 40 left,22 right.According to the postoperative drainage methods were divided into internal drainage group(double J tube,perirenal drainage tube)and external drainage group(nephrostomy tube,ureteral stent,perirenal drainage tube).There were 36 cases that including 28 men and 8 women,24 cases on the left and 12 cases on the right side of the internal drainage group.There were 26 cases of external drainage group,including 22 men and 4 women,16 cases on the left and 10 cases on the right.According to the standard of the urology grading system of the Fetal Urology Association,hydronephrosis was identified as antero-posterio(AP)> 20 mm and accompanied by caliectasis.Among them,there were no mild cases,mild 1 case and severe 35 cases in the internal drainage group,0 cases were mild in the external drainage group,5 cases were moderate and 21 cases were severe.All cases were accompanied by dilatation of the renal pelvis,amd all the pathological findings proved stricture at the junction of ureter.Comparison of the two groups in general,operation time,postoperative hospital stay,intraoperative blood loss,postoperative complications and follow-up of hydronephrosis after the recovery,to evaluated the effection and analyzed statistically.Results 1.There was no significant difference between the two groups in terms of age,sex,or side.2.In the internal drainage group,mean operative time was 75.83±12.50 minutes,mean intraoperative blood loss was 11.89±8.26 ml,the mean time of postoperative hospital stay was 13.75±5.22 d,the incidence rate of urinary infection 1,postoperative 3 days abdominal pain 2,stenosis 2,scaling 1,postoperative hematuria time 2.67±2.04 d.3.In the external drainage group,mean operative time was 93.46±19.17 minutes,mean intraoperative blood loss was 15.15±13.86 ml,the mean time of postoperative hospital stay was 22.27±6.90 d,the incidence rate of urinary infection 3,postoperative 3 days abdominal pain 8,stenosis 2,scaling 0,postoperative hematuria time 2.65±1.77 d.4.Comparing the results of the the internal drainage group with external drainage group,the mean operative time,the mean time of postoperative hospital stay and the the total incidence of postoperative complications were statistically significant differences,but the mean intraoperative blood loss,the postoperative hematuria time,the incidence rate of urinary infection,stenosis and scaling were no significant differences.Conclusion Double J tube drainage after Anderson-Hynes Pyeloplasty can shorten the time of operation and hospitalization,reduce the postoperative complications.