Recovery of renal function and morphology after Anderson-Hynes operation during short and middle-term follow-ups

Abstract

Objective To explore the recovery of renal function and morphology after Anderson-Hynes operation to provide rationales of duration and potential influencing factors for follow-ups. Methods A total of 42 ureteropelvic junction obstruction (UPJO) patients undergoing Anderson-Hynes between 2012 and 2015 were retrospectively evaluated. The average operative age was 38.5 months and average follow-up period was 38 months. Clinical data were analyzed by SPSS19, analysis of variance, t test and chi-square test. Results Grades of renal histopathological changes: differential renal function (DRF) ≥35% preoperatively predominantly showed minimal histopathological changes (grade I) and DRF<35% preoperatively moderate to severe obstructive changes (grades II & III). Grade I DRF improved 13.03%, grade II-III DRF improved 7.97% at Year 1 postoperatively. Renal morphology: renal cortex, anteroposterior diameter (APD), the deepest diameter of hydronephrosis and longitudinal section area changed statistically significant since Month 6, peaked initially at Month 12 but unsteadily, fluctuated during Months 12-24 and peaked steadily at Month 36. Renal function: At 1 year postoperatively, besides improved DRF, GFR, peak time, diuretic T1/2 and curve were statistically significant. Conclusions The postoperative follow-up duration for Anderson-Hynes should be more than 3 years. Grades of renal histopathological changes may affect recovery. Besides APD and DRF, GFR, peak time, diuretic T1/2 and curve may be analyzed comprehensively for recovery of renal function. Key words: Kidney function tests; Kidney pelvis; Ureter; Follow-up studies