Abstract

AİM: To evaluate tlıe incisions and surgical tecniques for the repair of ureteropelvic junction (UPJ) obstrution in childhood. MATERIAL and METHOD: One hundred children underwent open surgical intervention for pelviureteric jnnction obstraction between 1995-2000. Average age of patients was 5.6 (3 moon to 16 yrs). Lesions were on left the side in 61 patients, on right side in 31 and bilateral in eight. A total of 104 operations were performed: Scardino pelvic flap pyeloplasty technique was employed in 45 patients (43%), Anderson-Hynes dismembered pyeloplasty technique in 26(26%), Y-V pyeloplasty technique in 18 patients (17%). 15 patients underwent nephrectomy beeause of non-functioning kidneys (14%). Surgical approach varied; anterior extraperitoneal approach was selected in 53 patients (51%) forty-six patients were operated via anterior transperitoneal approach (44%) and flank incision was preferred in 5 patients that underwent pyeloplasties space patients with Y-V plasties. A penrose drain was inserted to perirenal space and placed near anastomosis to all patients with pyeloplasties. RESULTS: Successsful results were obtained with all pyeloplasty technique. None of the patients suffered any wound complications or perirenal urinoma. Mild urinary leak drained with penrose drains was observed in 8 patients after removal of the nephrostomy and stent but did not continue after eleventh postoperative day. CONCLUSIONs Surgical tecnique has to be chosen peroperatively in UPJ obstruction in childhood. Length of the stenotic segment, place of insertion of the ureter to the pelvis are importante Scardino pelvic flap pyeloplasty seems a safe and effective technique to employ in the patients whose stenotic ureter segment is long. Anterior extraperitoneal incision is the safest route to reach the kidney.