Transpelvic anastomotic stenting: a good option for diversion after pyeloplasty in children.

PURPOSE: Several options are available to drain the renal pelvis after a dysmembered pyeloplasty. The purpose of our study was to review the results of transrenal pelvic transanastomotic stenting following ureteropelvic junction obstruction pyeloplasty (UPJO). PATIENTS AND METHODS: A retrospective chart review of 238 patients with UPJO (243 renal units) treated in 2004-2007. The patients were divided into 4 groups (1): renal units with very poor function (<10% uptake) having undergone nephrostomy tube placement, with pyeloplasty performed 1 month later for those with improved renal function, and nephrectomy for those with no improvement (2); pyeloplasty without diversion (3); pyeloplasty diverted with transrenal pelvis transanastomotic stenting (4); pyeloplasties diverted with both stents and Foley catheters; the stents used were 5 Fr or 6 Fr feeding tubes. RESULTS: Group 1: 13 nephrectomies and 31 pyeloplasties diverted with stents and Foley catheters; 1/31 re-do pyeloplasty. Group 2: 33 pyeloplasties that were performed without diversion or stenting; 2/33 required re-do pyeloplasty. Group 3: 122 pyeloplasties diverted with only stents inserted through renal pelvis with 1 nephrostomy due to urine leakage, 2 prolonged urine leaks that ceased spontaneously, 1 urinary infection, no re-do pyeloplasty needed. Group 4: 44 pyeloplasties that were performed with stents and nephrostomy tubes, 2 delays of removal of Foley catheters, no re-do pyeloplasty needed. CONCLUSIONS: Transrenal pelvis transanastomotic stenting using a feeding tube is a good option for diverting urine following dysmembered pyeloplasty in children.

Perineal canal in children with normal anus: epidemiology, clinical and treatment

A prospective study was carried out on 120 perineal canal patients with normal anus who were treated at Pediatric Hospital, Ho Chi Minh City from September 1999 to August 2003. Patients were divided into group I: active inflammation, group II: vulvar excoriation, group III: no inflammation. Group I and II were treated medically until no more inflammation. The fistula was closed by the Tsuchida’s technique. Results: there were 2 patients healed spontaneously after internal treatment and 118 patients were closed fistula, among them there were 90 cases without colostomy and 28 with colostomy. There were 72 patients in group I, 12 in group II, and 34 in group III. Recurrence occurred in three cases without colostomy and one case with colostomy. One among these 3 without colostomy and the only one with colostomy were treated again with good result by the same procedure

Preliminary results of using tsuchida operation for treatment of anovestibular fistula in children with normal anus

From September 1999 to August 2003, 118 cases of perineal canal or anorectovestibular fistula were treated at the Pediatric Hospital No 1, HCM City using Tsuchida technique, among them, 90 cases without colsotomy and 28 cases with colostomy. The operation was carried as follows: excision of the fistula and an anterior haft of rectal wall below the fistula, the free intact proximal wall of rectum was directly sutured tissue of anus at its anterior circumference. After 3 months: there were 3 recurrence of fistula among no- colostomy cases and one recurrence among the colostomy cases. On case without and 1 with colostomy had been reoperated. Result were satisfied