Anderson-Hynes open pyeloplasty: Which indications in the area of laparoscopic surgery?

Objectives. - To evaluate the results of Anderson-Hynes open pyeloplasty in our institution. And then to compare them to those of laparoscopic procedure and identify what can be considered now as the indications of the open procedure. Patients and methods. - It was a retrospective study on 30 cases of ureteropelvic junction syndrome managed by Anderson-Hynes open procedure. The clinical, biological and radiologic characteristics of the patients as well as the surgical technique and its results were taken into account. The patients were classified, according to Valdeyer and Cendron classification as type II in eight cases (26.7%), type III in ten cases (33.3%) and type IV in four cases (13.3%). There were also eight cases of giant hydronephrosis (26.7%). The operating time, the length of hospital stay and the outcomes were studied and compared with those of the laparoscopic pyeloplasty found in the medical literature. Results. - The mean operating time was 115 +/- 33.4 minutes (90-230 min). The mean length of hospital stay was 10.4 +/- 5.1 days. Six patients (20%) had postoperative complications. After a mean follow-up of 28 +/- 13.7 months (13-48 months), our first-hand success rate was 90% (n=27). Conclusion. - Anderson-Hynes open pyeloplasty reached good results but nowadays its indications can be limited to laparoscopic contraindications, severe hydronephrosis (grade IV or giant hydronephrosis) and second-hand cases. The two latter indications depend on the surgeon experience in laparoscopic surgery. (C) 2012 Elsevier Masson SAS. All rights reserved.