Ciro Esposito1, Francois Varlet2, Dariusz Patkowski3, Marco Castagnetti4, Maria Escolino5, Isabela Magdalena Draghici6, Alessandro Settimi5, Antonio Savanelli5, Holger Till7. 1. Department of Translational Medical Sciences, Federico II University of Naples, Via Pansini 5, 80131, Naples, Italy. ciroespo@unina.it. 2. Department of Pediatric Surgery, Centre Hospitalier Universitaire, Hopital Nord, Saint-Étienne, France. 3. Department of Pediatric Surgery, Wroclaw University, Wroclaw, Poland. 4. Department of Pediatric Surgery, University of Padua, Padua, Italy. 5. Department of Translational Medical Sciences, Federico II University of Naples, Via Pansini 5, 80131, Naples, Italy. 6. Department of Pediatric Surgery, Maria Sklodowska Curie Hospital for Children, Bucharest, Romania. 7. Department of Pediatric Surgery, Medical University of Graz, Graz, Austria.
Abstract
BACKGROUND: We aim to report a 5-year retrospective multicentric European survey about the outcome of laparoscopic partial nephrectomy in infants and children with duplex kidneys. METHODS: The data of fifty-two children underwent laparoscopic partial nephrectomy (42 upper-pole nephrectomies and 10 lower-pole nephrectomies) in six European centers of Pediatric Surgery, were collected and analyzed. Median age at surgery was 5.1 years (range 6 months-9.7 years). There were 32 girls and 20 boys. In 37 patients, the left side was affected and in 15 patients the right side. For the right side, 4 trocars were used and for the left side 3/4 trocars. Special hemostatic devices were used for dissection and parenchymal section in all centers. We assessed intraoperative and postoperative morbidity. RESULTS: Median length of surgery was 166.2 min (70-215 min). No conversion to open surgery nor intraoperative bleeding was reported. Mean hospitalization was 3.5 days. We recorded 10/52 complications (4 urinomas, 2 recurrent UTIs, 4 prolonged urinary leakage), all managed conservatively. Reoperation rate was 0%. No loss of renal function on the residual kidney moiety was recorded in all operated patients. CONCLUSIONS: Laparoscopic partial nephrectomy remains a technically challenging procedure performed only in pediatric centers with high experience in minimally invasive surgery. Although the median operative time was higher than 2 h, we recorded no conversions in our series. The complication rate remains high (10/52-19.2%). All were II grade complications according to Clavien-Dindo classification and were treated conservatively without the need of other surgical procedures.
BACKGROUND: We aim to report a 5-year retrospective multicentric European survey about the outcome of laparoscopic partial nephrectomy in infants and children with duplex kidneys. METHODS: The data of fifty-two children underwent laparoscopic partial nephrectomy (42 upper-pole nephrectomies and 10 lower-pole nephrectomies) in six European centers of Pediatric Surgery, were collected and analyzed. Median age at surgery was 5.1 years (range 6 months-9.7 years). There were 32 girls and 20 boys. In 37 patients, the left side was affected and in 15 patients the right side. For the right side, 4 trocars were used and for the left side 3/4 trocars. Special hemostatic devices were used for dissection and parenchymal section in all centers. We assessed intraoperative and postoperative morbidity. RESULTS: Median length of surgery was 166.2 min (70-215 min). No conversion to open surgery nor intraoperative bleeding was reported. Mean hospitalization was 3.5 days. We recorded 10/52 complications (4 urinomas, 2 recurrent UTIs, 4 prolonged urinary leakage), all managed conservatively. Reoperation rate was 0%. No loss of renal function on the residual kidney moiety was recorded in all operated patients. CONCLUSIONS: Laparoscopic partial nephrectomy remains a technically challenging procedure performed only in pediatric centers with high experience in minimally invasive surgery. Although the median operative time was higher than 2 h, we recorded no conversions in our series. The complication rate remains high (10/52-19.2%). All were II grade complications according to Clavien-Dindo classification and were treated conservatively without the need of other surgical procedures.
Authors: C Esposito; M Iaquinto; M Escolino; A Farina; A La Manna; A Savanelli; A Settimi; A Di Mezza Journal: Minerva Urol Nefrol Date: 2014-06 Impact factor: 3.720
Authors: David S Wang; Vincent G Bird; Christopher S Cooper; J Christopher Austin; Howard N Winfield Journal: Can J Urol Date: 2004-02 Impact factor: 1.344