Literature DB >> 21883858

Early comparison of nephrectomy options in children (open, transperitoneal laparoscopic, laparo-endoscopic single site (LESS), and robotic surgery).

Philip H Kim1, Mukul B Patil, Steve S Kim, Frederick Dorey, Roger E De Filippo, Andy Y Chang, Brian E Hardy, Inderbir S Gill, Mihir M Desai, Chester J Koh.   

Abstract

OBJECTIVE: To compare the perioperative parameters of paediatric patients who underwent nephrectomy via laparo-endoscopic single site (LESS) surgery (also known as single incision laparoscopic surgery or SILS) with those who underwent nephrectomy via conventional laparoscopy (LAP), robotic-assisted laparoscopy (RALN), and open surgery (OPEN). PATIENTS AND METHODS: The medical records of 69 paediatric patients at a single institution who underwent nephrectomies for non-functioning kidneys in 72 renal units (39 OPEN, 11 LAP, 11 RALN and 11 LESS) were reviewed for patient demographics and perioperative clinical parameters.
RESULTS: The minimally invasive modalities in children, including LESS nephrectomy, were associated with shorter lengths of hospital stay (P < 0.001) and decreased postoperative pain medication usage (P < 0.001) than with open surgery. Similar surgical times were noted with LESS and the other minimally invasive modalities (LAP and RALN) (P= 0.056). However, the minimally invasive modalities (LESS, LAP and RALN) were associated with slightly longer surgical times when compared with open surgery (P < 0.001), which may, in part, be secondary to learning curve factors. No differences were noted among the minimally invasive modalities for postoperative pain medication usage (P= 0.354) and length of hospital stay (P= 0.86).
CONCLUSIONS: The minimally invasive modalities for nephrectomy in children, including LESS nephrectomy, are associated with shorter lengths of hospital stay and decreased postoperative pain medication use when compared with open surgery. LESS nephrectomy in children is associated with similar surgical times, lengths of hospital stay and postoperative pain medication use as the other minimally invasive modalities (LAP and RALN). Slightly longer surgical times are noted with the minimally invasive modalities, including LESS nephrectomy, when compared with open surgery, which may, in part, be secondary to learning curve factors.
© 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

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Year:  2011        PMID: 21883858     DOI: 10.1111/j.1464-410X.2011.10524.x

Source DB:  PubMed          Journal:  BJU Int        ISSN: 1464-4096            Impact factor:   5.588


  4 in total

Review 1.  Laparoendoscopic single-site surgery in kidney surgery: clinical experience and future perspectives.

Authors:  Panagiotis Kallidonis; Stavros Kontogiannis; Iason Kyriazis; Ioannis Georgiopoulos; Abdulrahman Al-Aown; Jens-Uwe Stolzenburg; Evangelos Liatsikos
Journal:  Curr Urol Rep       Date:  2013-10       Impact factor: 3.092

Review 2.  Minimally invasive surgery in management of renal tumours in children.

Authors:  Kathrine Olaussen Eriksen; Navroop Singh Johal; Imran Mushtaq
Journal:  Transl Pediatr       Date:  2016-10

Review 3.  What's the best minimal invasive approach to pediatric nephrectomy and heminephrectomy: conventional laparoscopy (CL), single-site (LESS) or robotics (RAS)?

Authors:  Holger Till; Ali Basharkhah; Andras Hock
Journal:  Transl Pediatr       Date:  2016-10

4.  Laparoendoscopic single site surgery in pediatric urology: does it require specialized tools?

Authors:  Nishant Patel; Michael Santomauro; Sarah Marietti; George Chiang
Journal:  Int Braz J Urol       Date:  2016 Mar-Apr       Impact factor: 1.541

  4 in total

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