Complications and Late Outcome in Transperitoneal Laparoscopic Heminephrectomy for Duplex Kidney in Children

Cabezalí, Daniel; Maruszewski, Przemysław; Lopez, Francisco Baron; Aransay, Adolfo; Gómez, Andrés

doi:10.1089/end.2012.0379

Cited by 26 publications

(6 citation statements)

References 23 publications

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“…Magnification and fine movements allow for accurate dissection of the injured renal moiety, and limited dissection of Set-up time the remaining renal polea risk that could result in its perioperative injury or in torsion after surgery. 27 To improve the safety of the pedicle dissection, particularly in cases of complex vascular anatomy, fluorescence imaging systems have proven to be a valuable additional tool for the surgical robotic console. 28 Although we have yet to gain experience with this, robot-assisted dissection so far has not resulted in renal loss or severe complications in our series.…”

Section: Discussionmentioning

confidence: 99%

Partial nephrectomy for small children: Robot‐assisted versus open surgery

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Partial nephrectomy for small children: Robot‐assisted versus open surgery

et al. 2017

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“…Опасным интраоперационным осложнением является кровотечение, которое может возникать из почечных сосудов и из паренхимы почки. По литературным данным, значительное кровотечение в процессе операции отмечено в 6-10% случаев, при этом в последние годы это осложнение развивается редко в связи с развитием лапароскопической техники, улучшением визуализации и применением современных методов хирургического гемостаза [6]. В нашем исследовании мы не наблюдали выраженного кровотечения ни во время операции, ни в раннем послеоперационном периоде.…”

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The Results of Laparoscopic Heminephrureterectomy and Ureteropyeloanastomosis (Ureteroureteroanastomosis) for Duplex Kidney in Children

Дубров¹,

Strotsky²,

Roienko³

et al. 2021

Novosti Khirurgii

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Objective. To study the results of laparoscopic heminephrureterectomy (LHNE), ureteropyelostomy (LUPS) and ureteroureterostomy (LUUS) in the laparoscopic treatments of megaurete of a duplex system in children. Methods. The records of patients (n=102) who underwent LHNE and LUPS (LUUS) were retrospectively analyzed (26 (25,5%) boys and 76(74,5%) girls). The age of patients was from 3 months to 17 years (median - 17.9 months). Megaureter of the upper pole was observed in 82 (80.4%) patients, of the lower pole - in 20 (19.6%). LHNE was performed in 68 patients (66.7%), LUPA (LUUA) - in 34 (33.3%). Results. Intraoperative complications occurred in 2 patients (2.0%), conversion was required in both cases. Median operative LHNE time was 146,0±46,2 minutes (median - 120 minutes); in LUPS(LUUS) - 160,1±44,7 minutes (median - 150 minutes). One patient after LUUA developed the urinary leakage due to stent obstruction and required nephrostomy (IIIb, Clavien-Dindo classification). The remote results were traced for a period from 10 months to 6 years.The patients after LHNE (n=15) (22.1%) had a significant decrease of kidney function (>5%), including one patient (1.5%) with a complete loss of the function. An inflammatory process after partial ureteral resection was observed in the stump , which required relaparoscopy in 3 children (6.5%). The ipsilateral ureter injury during the total ureterectomy in the lateral position occurred in 2 children (6.9%). Conclusion. LHNE and LUPA (LUUA) are considered to be the effective surgical methods of duplex system megaureter in children. The disadvantage of LHNE is the high risk of significant decrease of kidney function; LUPA (LUUA) are the safer methods. Total ureterectomy in the supine position of a patient can prevent the complications associated with the healthy ureter injury and leaving the ureteral stump. What this paper adds For the first time, it has been proven that laparoscopic heminephrectomy in comparison with laparoscopic ipsilateral ureteropyeloanastomosis or ureteroureteroanastomosis is considered to be an unsafe operation, since this can cause kidney failure. It has been established that total ureterectomy in the supine position of a patient can prevent the complications associated with the healthy ureter injury and leaving the ureteral stump.

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“…After the first description of LPN in children by Jordan and Winslow more than 20 years ago in 1993 (7), this procedure seems to be considered the gold standard and to have replaced the open approach (17)(18)(19)(20). This procedure can be c a r…”

Section: Discussionmentioning

confidence: 99%

Retroperitoneal and laparoscopic heminephrectomy in duplex kidney in infants and children

et al. 2017

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MIS now represents the gold standard technique to perform partial nephrectomy in children with duplex kidney. Our results demonstrate that RPN remains a technically demanding procedure with a significantly higher complications and re-operation rate compared to LPN. In addition, length of surgery and hospitalization were significantly shorter after LPN compared to RPN. LPN seems to be a faster, safer and technically easier procedure to perform in children compared to RPN due to a larger operative space and the possibility to perform a complete ureterectomy in refluxing systems.

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Complications and Late Outcome in Transperitoneal Laparoscopic Heminephrectomy for Duplex Kidney in Children

Abstract: The anatomic and functional outcomes of LH must be evaluated with imaging studies and nuclear scintigraphy to rule out structural abnormalities and functional impairment. An extensive dissection in the lower pole LH can lead to the upper moiety torsion after surgery.

Cited by 26 publications

References 23 publications

Partial nephrectomy for small children: Robot‐assisted versus open surgery

Partial nephrectomy for small children: Robot‐assisted versus open surgery

The Results of Laparoscopic Heminephrureterectomy and Ureteropyeloanastomosis (Ureteroureteroanastomosis) for Duplex Kidney in Children

Retroperitoneal and laparoscopic heminephrectomy in duplex kidney in infants and children

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