Retroperitoneal and laparoscopic heminephrectomy in duplex kidney in infants and children

Esposito, Ciro; Escolino, Maria; Castagnetti, Marco; Savanelli, Antonio; Manna, Angela La; Farina, Alessandra; Turrà, Francesco; Roberti, Agnese; Settimi, Alessandro; Varlet, François; Till, Holger; Js, Valla

doi:10.21037/tp.2016.09.12

Cited by 13 publications

(5 citation statements)

References 29 publications

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“…19 Furthermore, many authors report reduced visibility in the retroperitoneal method. 14,17 The study presents several limitations. The patient groups are not age-matched, the sample size is limited, and the study is retrospective and non-randomized, which limits its clinical use.…”

Section: Discussionmentioning

confidence: 95%

“…The international multicenter study conducted by Esposito et al 14 analyzed the transperitoneal and retroperitoneal methods among 102 patients (52 and 50, respectively). The transperitoneal method had a shorter operation time (166 vs 255 minutes; P < 0.001) and hospital stay (3.5 vs 4.1 days; P < 0.001).…”

Section: Discussionmentioning

confidence: 99%

“…8,[10][11][12][13] However, minimally invasive surgery remains technically challenging and involves a learning curve. [14][15][16] Implementation of such methods is limited to specialized centers, which reduces the scope of its usability despite the obvious benefits. Few studies had been published in recent years comparing transperitoneal laparoscopic and open approaches.…”

Section: Introductionmentioning

confidence: 99%

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Heminephrectomy in the pediatric population – single-center comparison of the open versus transperitoneal laparoscopic approach

Starczewski,

Choiński,

Puliński

2023

Pol. Ann. Med.

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IntroductionHeminephrectomy is considered the method of choice in the treatment of symptomatic or poorly working moiety of a duplex kidney as well as in oncology.AimThe study aims to retrospectively analyze the laparoscopic approach to heminephrectomy (LHN) in comparison with the open approach (OHN).Material and methodsFrom 2011 to 2020, 28 heminephrectomies were performed in the Clinical Ward of Pediatric Surgery and Urology of the Regional Specialized Children’s Hospital in Olsztyn: 10 with the laparoscopic transperitoneal method (LHN), and 18 with the open method (OHN). The mean age was 37.4 months (1–197 months). In total, 20 patients were female, and 8 were male. Loss of function of the moiety was a prerequisite for surgery. Hydronephrosis, dysplasia of the moiety, and vesicoureteral reflux were the most prevalent in both groups. Data regarding patients were collected based on available medical documentation and retrospectively analyzed.Results and discussionThere was no significant difference between the LHN and OHN groups regarding mean operating time (157 vs 128 minutes; P = 0.226) and mean postoperative hospital stay (5.20 vs 6.53; P = 0.64). The refeeding time is comparable and not statistically significant (1.90 vs 1.83 days; P = 0.555). Postoperative analgesic intake was found to be significantly lower (10.4 vs 17.5 doses, P = 0.004).ConclusionsBoth open and laparoscopic approaches are safe and feasible in the pediatric population. Both are comparable in operative time, hospital stay and refeeding time. LHN displays a better cosmetic effect and requires significantly lesser analgesic use.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Heminephrectomy in the pediatric population – single-center comparison of the open versus transperitoneal laparoscopic approach

Starczewski,

Choiński,

Puliński

2023

Pol. Ann. Med.

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“…However, literature reflects a rather higher rate of conversion and a higher complication rate for retroperitoneoscopic partial nephrectomy than for the laparoscopic procedure. Esposito et al published his results of a multicentric study including 102 patients undergoing partial nephrectomy in a 5 years period either by a laparoscopic or a retroperitoneoscopic approach (9). In his series, the overall complication rate was significantly higher for the retroperitoneoscopic group than for the laparoscopic group, respectively.…”

Section: Laparoscopic Surgery On the Upper Urinary Tractmentioning

confidence: 99%

Applications of Laparoscopic Transperitoneal Surgery of the Pediatric Urinary Tract

Szavay

2019

Front. Pediatr.

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Application of laparoscopy in pediatric urology has evolved over more than 30 years coming from a merely diagnostic use for non-palpable testes to “interventional” laparoscopy to extirpative surgery and finally to the era of reconstructive pediatric laparoscopic urology, when in 1995 Peters described the first laparoscopic pyeloplasty in a child. Laparoscopic surgery in pediatric urology became implemented increasingly in the twenty-first century with now present-day applications including the complete variety of all kind of indications for surgery for pediatric urological pathology. This article aims to provide a comprehensive overview of current indications, techniques, and outcomes of laparoscopic transperitoneal surgery of the upper as well as of the lower urinary tract for urological pathology in the pediatric patient population.

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“…Due to the lack of experience among surgeons in aspects of the retroperitoneal anatomy and the long operation time, the retroperitoneal laparoscopic technique has not been widely applied among pediatric surgeons[6]. Herein, we report our exper-ience with a retroperitoneal laparoscopic surgery for duplex kidney.…”

Section: Introductionmentioning

confidence: 99%

Retroperitoneoscopic approach for partial nephrectomy in children with duplex kidney: A case report

Chen

Wang

et al. 2019

WJCC

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BACKGROUND Renal duplication is a common deformity of the urinary system, with an incidence of approximately 1/125 in children. Symptomatic patients with hydronephrosis, vesicoureteral reflux, or incontinence may require surgical interventions. Laparoscopy and retroperitoneoscopy are the two main accesses for partial nephrectomy. CASE SUMMARY A 9-year-old child was admitted to the hospital for hydronephrosis of the left kidney. Ultrasonography showed that the left kidney was larger, approximately 12.6 cm × 6.3 cm × 5.5 cm in size, with visible separation of the pelvis and an obviously separated lower portion. The upper segment of the left ureter was dilated (approximately 2.6 cm in width), and no significant dilation was observed in the middle and upper segments. The right kidney and ureter were normal. Primary diagnosis was left renal duplication malformation and hydronephrosis. Retroperitoneal laparoscopic nephrectomy and ureterectomy were performed. Intraoperative exploration revealed a dilated pelvis and thin renal parenchyma at the lower pole of the left kidney. The upper left kidney was smaller than normal, and the pelvis and ureter were larger than normal. The renal artery was blocked for 40 min. A hemolock was used to clamp down the kidney ureter, and a drainage tube was retained in the retroperitoneal cavity. The operation was uneventful, and the estimated amount of blood loss was 100 mL. Total abdominal drainage amount was 116 mL. The drainage tube was removed on postoperative day (POD) 3 and the patient was discharged on POD6. The pathological diagnosis confirmed the atrophy of the renal parenchyma, the dilation of the renal pelvis, hydronephrosis, and ureteral cystic dilation. CONCLUSION The retroperitoneoscopic approach for partial nephrectomy is feasible and effective in selective pediatric patients with a duplex kidney.

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Retroperitoneal and laparoscopic heminephrectomy in duplex kidney in infants and children

Cited by 13 publications

References 29 publications

Heminephrectomy in the pediatric population – single-center comparison of the open versus transperitoneal laparoscopic approach

Heminephrectomy in the pediatric population – single-center comparison of the open versus transperitoneal laparoscopic approach

Applications of Laparoscopic Transperitoneal Surgery of the Pediatric Urinary Tract

Retroperitoneoscopic approach for partial nephrectomy in children with duplex kidney: A case report

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