A comparison of the lateral and posterior retroperitoneoscopic approach for complete and partial nephroureterectomy in children

Borzi, P. A. (2001) A comparison of the lateral and posterior retroperitoneoscopic approach for complete and partial nephroureterectomy in children. Bju International, 87 6: 517-520.


Author Borzi, P. A.
Title A comparison of the lateral and posterior retroperitoneoscopic approach for complete and partial nephroureterectomy in children
Journal name Bju International   Check publisher's open access policy
Publication date 2001
Sub-type Article
DOI 10.1046/j.1464-410X.2001.00130.x
Volume number 87
Issue number 6
ISSN 1464-4096
Start page 517
End page 520
Total pages 4
Place of publication England
Publisher Blackwell
Collection year 2001
Language eng
Subject C1
321029 Surgery
730204 Child health
Abstract Objective To report the comparative results of a selective posterior or lateral retroperitoneoscopic approach (RPA) for nephroureterectomy in children. Patients and methods Following an established experience with RPA, 36 complete and 19 partial nephrouretectomies were prospectively randomized to a posterior and lateral retroperitoneoscopic approach. The patients were aged 4 months to 14 years, with a body weight at operation of 5.7-82 kg. For posterior RPA the child is positioned prone, with three access ports. The operating space was created with balloon dissection and maintained with CO2 insufflation. The child was then rotated 30 degrees with the kidney in the dependent position, and the operator and assistant standing on the affected side. In the lateral approach the child is in the lateral decubitus position with the operator and assistant facing the dorsal aspect of the patient. Results There was no significant difference in operative duration between the lateral and posterior approaches for nephrectomy (65 and 47 min) or partial nephrectomy (85 and 75 min). Two lateral nephrectomies required open conversion (one upper pole and one lower pole). Conclusion The posterior approach gives easy and quick access to the renal pedicle. It is preferable for complete nephrectomy alone and partial or polar excision. In children under 5 years old a near complete ureterectomy can be achieved. The lateral approach creates more inferomedial space, gives better access to ectopic kidneys and allows complete ureterectomy in all cases, Access to the pedicle in the normal position requires more frequent positioning of the kidney. Care must be taken as peritoneal tears are more common.
Keyword Urology & Nephrology
Laparoscopy
Retroperitoneoscopy
Nephrectomy
Children
Experience
Q-Index Code C1

Document type: Journal Article
Sub-type: Article
Collection: School of Medicine Publications
 
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Created: Tue, 14 Aug 2007, 16:50:55 EST