Innovative Journal Journal of Medical Biomedical and Applied Sciences 2277:4939 10 06 Primary Ureterocalycostomy for complicated upper urinary tract obstruction in solitary kidney: challenging but effective. 1 Dr. Priyanka Rai Dr RMLIMS LUCKNOW (DEPTT OF GENERAL SURGERY), 226010 LUCKNOW Dr. Sunil Kumar Singh Dr RMLIMS LUCKNOW (DEPTT OF GENERAL SURGERY), 226010 LUCKNOW . Dr. Rohit Srivastava Dr RMLIMS LUCKNOW INDIA (Department of Urology), 226010 lucknow Dr. Alok Srivastava Dr RMLIMS LUCKNOW (DEPTT OF GENERAL SURGERY), 226010 LUCKNOW Dr. Amarjot Singh Dr RMLIMS LUCKNOW INDIA (Department of Urology), 226010 lucknow . Journal Article Abstract Objective: To report our contemporary experience in operative management of complex upper urinary tract obstruction in solitary kidney patients. Material and method: From January 2014 to December 2018 , we have performed 9 cases of ureterocalycostomy in which 6 cases were of primary PUJ(Pelviureteric junction) obstruction with complete intrarenal pelvis with minimal hydronephrosis, 2 cases were post PCNL(Percutaneous Nephrolithomy) and one case of post RIRS(Retrograde Intrarenal surgery) proximal upper ureter stricture All patients subjected to ureterocalycostomy after control of sepsis . Open Flank approach was performed. Due to hypertrophy of kidney and intra renal pelvis, Guillotine lower pole partial nephrectomy was performed in all the cases. Ureterocalycostomy was done with the most dependent calyx over 6/26 DJS (Double J stent) followed by omental wrapping. Standard postoperative monitoring done. The recorded data included demographic profiling. Results: All the patients presented with pain, raised creatinine levels and sepsis. Patients mean age of presentation was 20.1 years, 6 were male and 3were female. Mean operative time was 129.5 minutes, mean blood loss was 100ml, mean cold ischemia time 30 minutes and mean hospital duration was 9.1 days. Out of two patients one patients had grade 1(clavein –dindo) and second had grade 3 (clavein –dindo) complications. All patients were asymptomatic for next 1 year follow up. Conclusions: Primary ureterocalycostomy with Guillotine lower pole partial nephrectomy, has resulted in satisfactory outcomes in patients with complex upper urinary tract obstruction and having solitary functioning kidney ,who are not candidates for other procedures, such as pyeloplasty. 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