Retroperitoneoscopic renal surgery in children: our experience.

Abstract

BACKGROUND:

Laparoscopic renal surgery has become an accepted approach for benign disease in adult and pediatric urology. We present our experience in renal laparoscopy in infants during the past 5 years and evaluate our series to establish the safety and efficacy of such procedures in children.

MATERIALS AND METHODS:

From August 1999 to December 2004, we performed 32 renal laparoscopic procedures on 31 children aged 12 months to 16 years (mean, 42 months). Twenty-seven patients underwent unilateral retroperitoneal nephrectomy; 1 child with Denis Drash syndrome underwent transperitoneal bilateral nephrectomy; 2 children underwent renal cyst unroofing; and 1 child with lymphoma underwent retroperitoneal laparoscopic renal biopsy. Indications for surgery were: renal function <9% in cases of unilateral nephrectomy; the prevention of renal neoplastic changes in the patient with Denys-Drash syndrome; symptomatic large renal cysts; and suspected lymphoma not diagnosed with a previous percutaneous biopsy.

RESULTS:

All procedures were completed laparoscopically. In 6 cases, the accidental opening of the peritoneum did not require conversion to open surgery. Intraoperative blood loss was minimal. One patient who underwent a retroperitoneal nephrectomy required a blood transfusion for postoperative bleeding into the retroperitoneal space. Twenty-four of 27 unilateral retroperitoneal nephrectomy patients were discharged on postoperative day 2. Mean follow-up was 30 months (range, 6-64 months). Cosmetic results were excellent in all patients and no long-term complications have been encountered so far.

CONCLUSION:

Laparoscopic urologic surgery may be performed in children with minimal morbidity, minimal postoperative discomfort, improved cosmetic results, and a short hospital stay.

• Authors: Barbara Tadini, Lorenzo Repetto, Nino Guarino, Roberto Lace, Efisia Marras, Marco Bianchi
• Journal: Journal of laparoendoscopic & advanced surgical techniques. Part A (J Laparoendosc Adv Surg Tech A) Vol. 16 Issue 3 Pg. 305-7 (Jun 2006) ISSN: 1092-6429 [Print] United States
• PMID: 16796447 (Publication Type: Journal Article)

Topics

• Adolescent
• Biopsy (methods)
• Child
• Child, Preschool
• Female
• Humans
• Infant
• Kidney Diseases (surgery)
• Laparoscopy (methods)
• Length of Stay (statistics & numerical data)
• Male
• Nephrectomy (methods)
• Treatment Outcome