Selective approach for transperitoneal and extraperitoneal endoscopic nephrectomy in children

Borzi, PA and Yeung, CK (2004) Selective approach for transperitoneal and extraperitoneal endoscopic nephrectomy in children. Journal of Urology, 171 2: 814-816. doi:10.1097/01.ju.0000108893.84835.e8


Author Borzi, PA
Yeung, CK
Title Selective approach for transperitoneal and extraperitoneal endoscopic nephrectomy in children
Journal name Journal of Urology   Check publisher's open access policy
ISSN 0022-5347
Publication date 2004-01-01
Sub-type Article (original research)
DOI 10.1097/01.ju.0000108893.84835.e8
Volume 171
Issue 2
Start page 814
End page 816
Total pages 3
Editor J. Gillenwater
Place of publication USA
Publisher Lippincott Williams & Wilkins
Collection year 2004
Language eng
Subject C1
321019 Paediatrics
321210 Community Child Health
730204 Child health
Abstract Purpose: From the experience of a large combined series of transperitoneal. (TP) and retroperitoneal (RP) endoscopic complete and partial nephroureterectornies in children, we present a logical selective endoscopic approach to benign renal pathology. Materials and Methods: During a 5-year period 122 complete nephrectomies and nephroureterectomies (bilateral 2, invisible ectopic 8) and 63 partial nephroureterectomies for duplex (52 upper, 8 lower) or singleton polar disease (xanthogranulomatous pyelonephritis 1, cyst 2) were performed. Of the partial nephrectomies, ureterectomy, bladder repair and lower moiety reimplantation were performed in 8. Patient age ranged from 2.7 months to 14 years (mean 2.9 years). Preoperative weight ranged from 2.7 to 98 kg (mean 12.3). The position of the renal remnant, the presence or absence of a refluxing ureter and the need for ureterectomy were the major determining factors affecting choice of endoscopic approach. Results: A total of 179 (96.7%) procedures were successfully completed endoscopically. The 6 open conversions (3.2%) occurred early in our experience. The operating time reflected the complexity of the excision and lower urinary reconstruction (lateral and posterior RP 25 to 145 minutes [mean 921) TP with ureterocelectomy and bladder neck repair 105 to 355 minutes [mean 153]. Hospital stay for RP and simple TP was 1.5 days (mean 1 to 4) and for complicated TP 2 to 8 days (mean 3.5). Conclusions: We suggest a posterior retroperitoneal approach with isolated renal excision without extended ureterectomy. The lateral retroperitoneal approach allows complete ureterectomy as well as better exposure to horseshoe and pelvic kidneys and, therefore, avoids exposure to intraperitoneal. structures. Finally, the transperitoneal approach is recommended when complete moiety excision with lower urinary reconstruction is anticipated.
Keyword Urology & Nephrology
Laparoscopy
Nephrectomy
Ureterocele
Pediatrics
Laparoscopic Nephrectomy
Ectopic Ureter
Retroperitoneoscopy
Experience
Management
Surgery
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2005 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Wed, 15 Aug 2007, 14:54:39 EST