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Comparison of Laparoscopic and Open Partial Nephrectomy for Duplication Anomalies in Children

2006; Lippincott Williams & Wilkins; Volume: 175; Issue: 6 Linguagem: Inglês

10.1016/s0022-5347(06)00342-9

1527-3792

Lisandro Piaggio, Julie Franc-Guimond, T. Ernesto Figueroa, Julia Spencer Barthold, Ricardo González,

Urological Disorders and Treatments

No AccessJournal of UrologyPediatric urology1 Jun 2006Comparison of Laparoscopic and Open Partial Nephrectomy for Duplication Anomalies in Children Lisandro Piaggio, Julie Franc-Guimond, T. Ernesto Figueroa, Julia S. Barthold, and Ricardo González Lisandro PiaggioLisandro Piaggio Division of Urology, A. I. duPont Hospital for Children, Wilmington, Delaware Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania , Julie Franc-GuimondJulie Franc-Guimond Division of Urology, A. I. duPont Hospital for Children, Wilmington, Delaware Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania , T. Ernesto FigueroaT. Ernesto Figueroa Division of Urology, A. I. duPont Hospital for Children, Wilmington, Delaware Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania , Julia S. BartholdJulia S. Barthold Division of Urology, A. I. duPont Hospital for Children, Wilmington, Delaware Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania , and Ricardo GonzálezRicardo González Division of Urology, A. I. duPont Hospital for Children, Wilmington, Delaware Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania View All Author Informationhttps://doi.org/10.1016/S0022-5347(06)00342-9AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We compared the outcome of laparoscopic vs open PN for duplication anomalies at our institution. Materials and Methods: We retrospectively reviewed the records of all patients undergoing PN within the last 4 years. Results: A total of 34 patients (16 females) were divided into 2 groups. Group 1 consisted of 20 patients undergoing open PN between 2000 and 2003, and group 2 consisted of 14 patients undergoing laparoscopic PN between 2003 and 2004. Mean patient age was 21 months in group 1 and 18 months in group 2. Diagnosis was ectopic ureter in 18 patients, ureterocele in 11, VUR in 4 and ureteropelvic junction obstruction in 1. Cystoscopy was performed as part of the procedure in 30% of the patients in group 1 and 100% of those in group 2. Simultaneous lower tract procedures were performed in 3 patients in group 1 and 2 patients in group 2. Mean duration of PN was 115 minutes for group 1 and 180 minutes for group 2. There was no significant bleeding or need for transfusion except in 1 patient in the open group. Median hospitalization was 3 days for group 1 and 2 days for group 2. Mean analgesic requirement was 2.3 doses of opioids and 2 doses of ketorolac for group 1, and 3.2 doses of opioids for group 2. Acetaminophen only was used in 3 of 20 patients in group 1 and 5 of 14 in group 2. There were 2 complications in each group, namely 1 case of ureteral bleeding and 1 lower pole ureteral injury in group 1, and 1 omental hernia and 1 urinoma in group 2. Conclusions: Laparoscopic PN is feasible even in small infants, and the results are comparable to the open procedure. Length of hospitalization was shorter in the laparoscopic group. In our series the learning curve for this technique was rapid, and after a few cases the procedure could be done in the same time as open surgery, with the advantages offered by laparoscopy. References 1 : A simplified technique for upper pole heminephrectomy for duplex kidney. J Urol2000; 164: 1326. Link, Google Scholar 2 : Management of ectopic ureters: experience with the upper tract approach. J Urol1997; 158: 1245. Link, Google Scholar 3 : Ureterocele associated with ureteral duplication and a nonfunctioning upper pole segment: management by partial nephrectomy alone. J Urol1995; 154: 723. Link, Google Scholar 4 : Laparoendoscopic upper pole partial nephrectomy with ureterectomy. J Urol1993; 150: 940. Link, Google Scholar 5 : Retroperitoneal laparoscopic vs open partial nephroureterectomy in children. BJU Int2003; 91: 532. Google Scholar 6 : Laparoscopic partial upper pole nephrectomy in infants and children. BJU Int2001; 87: 514. Google Scholar 7 : Laparoscopic heminephroureterectomy in pediatric patients. J Urol1997; 158: 1928. Link, Google Scholar 8 : Selective approach for transperitoneal and extraperitoneal endoscopic nephrectomy in children. J Urol2004; 171: 814. Link, Google Scholar 9 : Pediatric retroperitoneal laparoscopic partial nephrectomy: comparison with an age matched cohort of open surgery. J Urol2005; 174: 708. Link, Google Scholar 10 : Treatment of ureterocele on duplex ureter: upper pole nephrectomy by retroperitoneoscopy in children based on a series of 24 cases. Eur Urol2003; 43: 426. Google Scholar 11 : Laparoscopic renal surgery in children. J Urol1994; 151: 735. Link, Google Scholar 12 : Comparison of laparoscopic versus open partial nephrectomy in a pediatric series. J Urol2003; 169: 638. Link, Google Scholar 13 : The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatr Nurs1997; 23: 293. Google Scholar 14 : Nursing Care of Infants and Children. St. Louis: Mosby1991. p. 1148. Google Scholar 15 : Laparoscopic upper-pole heminephrectomy for ectopic ureter: surgical technique. J Endourol2003; 17: 469. Google Scholar 16 : Experience with the Bailez technique for laparoscopic access in children. J Urol2003; 170: 936. Link, Google Scholar 17 : Laparoscopic nephrectomy in children: the transperitoneal vs the retroperitoneal approach. Arch Esp Urol2003; 56: 401. Google Scholar 18 : Which approach? Transperitoneal or retroperitoneal for pediatric laparoscopic nephrectomy? 100 consecutive cases. J Laparoendosc Adv Surg Tech2005; 15: 209. Google Scholar 19 : A clinical series of laparoscopic nephrectomy, nephroureterectomy and heminephroureterectomy in the pediatric population. J Urol2000; 163: 1531. Link, Google Scholar 20 : Comparison of ketorolac and morphine as adjuvants during pediatric surgery. Anesthesiology1992; 76: 368. Google Scholar © 2006 by American Urological AssociationFiguresReferencesRelatedDetailsCited byFuchs J, Luithle T, Warmann S, Haber P, Blumenstock G and Szavay P (2009) Laparoscopic Surgery on Upper Urinary Tract in Children Younger Than 1 Year: Technical Aspects and Functional OutcomeJournal of Urology, VOL. 182, NO. 4, (1561-1568), Online publication date: 1-Oct-2009.Yucel S, Brown B, Bush N, Ahmad N and Baker L (2007) What to Anticipate With Experience in Pediatric Laparoscopic Ablative Renal SurgeryJournal of Urology, VOL. 179, NO. 2, (697-702), Online publication date: 1-Feb-2008.Chacko J, Koyle M, Mingin G and Furness P (2007) Minimally Invasive Open Renal SurgeryJournal of Urology, VOL. 178, NO. 4S, (1575-1578), Online publication date: 1-Oct-2007.Piaggio L, Franc-Guimond J, Noh P, Wehry M, Figueroa T, Barthold J and González R (2007) Transperitoneal Laparoscopic Pyeloplasty for Primary Repair of Ureteropelvic Junction Obstruction in Infants and Children: Comparison With Open SurgeryJournal of Urology, VOL. 178, NO. 4S, (1579-1583), Online publication date: 1-Oct-2007.Piaggio L and González R (2018) Laparoscopic Transureteroureterostomy: A Novel ApproachJournal of Urology, VOL. 177, NO. 6, (2311-2314), Online publication date: 1-Jun-2007.González R and Piaggio L (2018) Initial Experience With Laparoscopic Ipsilateral Ureteroureterostomy in Infants and Children for Duplication Anomalies of the Urinary TractJournal of Urology, VOL. 177, NO. 6, (2315-2318), Online publication date: 1-Jun-2007.Piaggio L, Noh P and González R (2018) Reoperative Laparoscopic Pyeloplasty in Children: Comparison With Open SurgeryJournal of Urology, VOL. 177, NO. 5, (1878-1882), Online publication date: 1-May-2007.González R (2018) Editorial CommentJournal of Urology, VOL. 176, NO. 6, (2639-2639), Online publication date: 1-Dec-2006. Volume 175Issue 6June 2006Page: 2269-2273 Advertisement Copyright & Permissions© 2006 by American Urological AssociationKeywordsnephrectomykidney diseasesurogenital abnormalitieslaparoscopyMetricsAuthor Information Lisandro Piaggio Division of Urology, A. I. duPont Hospital for Children, Wilmington, Delaware Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania More articles by this author Julie Franc-Guimond Division of Urology, A. I. duPont Hospital for Children, Wilmington, Delaware Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania Current address: Hôpital Sainte-Justine, University of Montreal, Montreal, Quebec, Canada. More articles by this author T. Ernesto Figueroa Division of Urology, A. I. duPont Hospital for Children, Wilmington, Delaware Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania More articles by this author Julia S. Barthold Division of Urology, A. I. duPont Hospital for Children, Wilmington, Delaware Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania More articles by this author Ricardo González Division of Urology, A. I. duPont Hospital for Children, Wilmington, Delaware Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania More articles by this author Expand All Advertisement PDF downloadLoading ...