Laparoscopic retroperitoneoscopic nephrectomy and partial nephrectomy in children

Abstract

Objectives:The aim was to evaluate our experience in the retroperitoneal laparoscopic approach in total and partial nephrectomies in children.Materials and Methods:We retrospectively reviewed the medical records of 41 patients who underwent retroperitoneal laparoscopic total or partial nephrectomies performed in our center from 2004 to 2012. We looked at the demographic data, age at surgery, indication, operative time, surgical complications, conversion to open surgery and operative complications.Results:Thirty-five total and six partial nephrectomies (upper pole) were performed. The mean age was 84 months (7-175). Vesicoureteric reflux, pelviureteric junction obstruction, and multicystic dysplastic kidney disease were the main underlying pathologies.The mean operative time was 158 min (60-280). There were no intraoperative complications (surgical and anesthetic), and no significant blood loss was observed. Conversion to open surgery was necessary in two cases caused by failure to progress due to difficult anatomy during the partial nephrectomies. No major postoperative complications were noted. The mean hospital stay was 2.5 days (1-5). A drain was used in 12 cases and was removed after a mean of 2 days.Conclusions:Laparoscopic retroperitoneoscopic renal surgery can be carried out safely and effectively in children. Still, this procedure is more challenging and requires an excellent image of the retroperitoneal space, especially when partial nephrectomies are concerned.

Laparoscopy or retroperitoneoscopy: which is the best approach in pediatric urology?

“…They concluded that both methods can be applied in children, but the PPR approach has the added advantage of using two trocars instead of three and is more suitable in patients who require bilateral nephrectomy. Al-Hazmi et al reported their experience in 35 patients who underwent laparoscopic lateral retroperitoneoscopic nephrectomy, the results of which were similar to those of previous studies (17). Valla et al presented their first 100 cases of retroperitoneoscopic lateral nephrectomy.…”

Designing Liquid‐Infused Surfaces for Medical Applications: A Review

“…The nature and type of fouling depend on the type of material in contact with the tubing – ranging from blood, urine, or medicine to microbe‐laden air – as well as the duration of contact, which can range from a few hours for intermittent‐use urinary catheters to over a year for some long‐term central venous access devices . For urinary catheters, fouling results in an infection rate of 5% per day, requiring patients to undergo recatheterization every 3–8 days to prevent urinary tract infections . In long‐term central venous catheters, the formation of thrombi or the precipitation of incompatible drug mixtures can result in occlusions, leading to pulmonary and other complications as well as increasing the chance of infection .…”

Selective renal segmental artery embolization for hydronephrotic upper renal moiety: simple alternative to standard surgical resection

“…The median hospital stay in patients without complications is 3.8 days. [10] In patients with renal arterial embolization, the mean hospital stay is around 2.3 days. [8] Schwartz et al [11] reported their experience in RAE performed in 121 patients over a 12 year period.…”

“…Since a non-functioning hydronephrotic kidney has minimal renal parenchyma, the actual incidence of PES is less, around 60%. [9] Coil related complications have also been studied by Capozza et al [10] They performed RAE as an alternative to surgical nephrectomy in 12 children with standard indications for nephrectomy. Revascularization after embolization was reported in one case and they concluded that a post procedure angiogram should be done in all cases to confirm successful embolization.…”