A Schneider1, M Ripepi, C Henry-Florence, S Geiss. 1. Pediatric Surgery Department, Centre de la Mère et de l'Enfant Le Parc, 46 rue du Stauffen, Colmar 68024, France. schneider.an@orange.fr
Abstract
OBJECTIVE: To report our experience with laparoscopic transperitoneal (TP) heminephrectomy for duplicated pyeloureteral systems in children under 2 years old. PATIENTS AND METHODS: We retrospectively reviewed the intraoperative evolution and patient outcome of 10 laparoscopic partial ureteronephrectomies (7 upper and 3 lower pole nephrectomies) using a TP approach, performed over 4 years. Mean age at surgery was 9.1 months (range 3.5-20.4), with seven children younger than 1 year. Average follow up based on clinical examinations and renal ultrasounds was 13.9 months (range 1.2-38.5). RESULTS: The average operative time was 123 min (range 90-195). There was no need for conversion and no intraoperative complications. Mean postoperative hospital stay was 2.9 days. A perirenal collection with spontaneous regression occurred in one case. The main postoperative complication consisted of a diminution in renal function with pyelic dilation in a 4-month-old child, due to inadequate positioning of the remaining moiety. This child remains asymptomatic 3 years after surgery. CONCLUSIONS: We recommend a TP approach for laparoscopic heminephrectomy due to the improved vascular exposure and control, diminished need for renal mobilization, and greater working space that can be obtained, especially in toddlers with a higher morbidity rate caused by the lack of retroperitoneal space.
OBJECTIVE: To report our experience with laparoscopic transperitoneal (TP) heminephrectomy for duplicated pyeloureteral systems in children under 2 years old. PATIENTS AND METHODS: We retrospectively reviewed the intraoperative evolution and patient outcome of 10 laparoscopic partial ureteronephrectomies (7 upper and 3 lower pole nephrectomies) using a TP approach, performed over 4 years. Mean age at surgery was 9.1 months (range 3.5-20.4), with seven children younger than 1 year. Average follow up based on clinical examinations and renal ultrasounds was 13.9 months (range 1.2-38.5). RESULTS: The average operative time was 123 min (range 90-195). There was no need for conversion and no intraoperative complications. Mean postoperative hospital stay was 2.9 days. A perirenal collection with spontaneous regression occurred in one case. The main postoperative complication consisted of a diminution in renal function with pyelic dilation in a 4-month-old child, due to inadequate positioning of the remaining moiety. This child remains asymptomatic 3 years after surgery. CONCLUSIONS: We recommend a TP approach for laparoscopic heminephrectomy due to the improved vascular exposure and control, diminished need for renal mobilization, and greater working space that can be obtained, especially in toddlers with a higher morbidity rate caused by the lack of retroperitoneal space.
Authors: Ciro Esposito; Maria Escolino; Marco Castagnetti; Antonio Savanelli; Angela La Manna; Alessandra Farina; Francesco Turrà; Agnese Roberti; Alessandro Settimi; Francois Varlet; Holger Till; Jean Stephan Valla Journal: Transl Pediatr Date: 2016-10
Authors: Joana Pereira; Angélica Osório; João Moreira-Pinto; José Cidade-Rodrigues; Carlos Enes; Armando Reis; João Ribeiro-Castro Journal: Case Rep Urol Date: 2011-12-08