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The Dorsal Lumbotomy Incision in Pediatric Urological Surgery

1987; Lippincott Williams & Wilkins; Volume: 138; Issue: 4 Part 2 Linguagem: Inglês

10.1016/s0022-5347(17)43472-0

1527-3792

Steven M. Orland, Howard M. Snyder, John W. Duckett,

Ureteral procedures and complications

No AccessJournal of Urology1 Oct 1987The Dorsal Lumbotomy Incision in Pediatric Urological Surgery Steven M. Orland, Howard M. Snyder, and John W. Duckett Steven M. OrlandSteven M. Orland More articles by this author , Howard M. SnyderHoward M. Snyder More articles by this author , and John W. DuckettJohn W. Duckett More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)43472-0AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Between January 1, 1983 and September 30, 1985, 42 upper urinary tract operations were performed using the dorsal lumbotomy incision, representing 28 per cent of all upper tract procedures performed. Operations included pyeloplasty, partial and total nephroureterectomy, pyelolithotomy, ureterolithotomy and renal exploration with cyst marsupialization. The major contraindications to lumbotomy were malignancy and malrotated or malpositioned kidneys. Patient age ranged from 1 month to 20 years. A modification of the Gil-Vernet vertical lumbotomy incision was used in all cases. This approach involves successive incisions through the layers of the lumbodorsal fascia to gain access to the kidney and ureter, and emphasizes a muscle-retracting technique. Incision of the costovertebral ligament allows 12th rib elevation and improves the exposure obtained. There were no postoperative complications related to the lumbotomy incision itself. Decreased surgical morbidity is suggested by our results. By 3 days postoperatively 64 per cent of our patients required no analgesic medication, 93 per cent were tolerating a regular diet and 83 per cent were evaluated as having a good appetite. Mean hospital length of stay for all lumbotomy patients was 5.6 days. We conclude that the dorsal lumbotomy incision can be used to perform a wide variety of upper tract operations in children, resulting in minimal morbidity and short hospital stays. © 1987 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byDUEL B, VATES T, HEISER D, BARTHOLD J and GONZALEZ R (2018) ANTEGRADE PYELOGRAPHY BEFORE PYELOPLASTY VIA DORSAL LUMBAR INCISIONJournal of Urology, VOL. 162, NO. 1, (174-176), Online publication date: 1-Jul-1999.WIENER J and ROTH D (2018) OUTCOME BASED COMPARISON OF SURGICAL APPROACHES FOR PEDIATRIC PYELOPLASTY: DORSAL LUMBAR VERSUS FLANK INCISIONJournal of Urology, VOL. 159, NO. 6, (2116-2119), Online publication date: 1-Jun-1998.Sutherland R and Gerow R (2018) Hernia After Dorsal Incision Into Lumbar Region: A Case Report and Review of Pathogenesis and TreatmentJournal of Urology, VOL. 153, NO. 2, (382-384), Online publication date: 1-Feb-1995.Wise W and Snow B (2018) The Versatility of the Posterior Lumbotomy Approach in InfantsJournal of Urology, VOL. 141, NO. 5, (1148-1150), Online publication date: 1-May-1989. Volume 138Issue 4 Part 2October 1987Page: 963-966 Advertisement Copyright & Permissions© 1987 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Steven M. Orland More articles by this author Howard M. Snyder More articles by this author John W. Duckett More articles by this author Expand All Advertisement PDF downloadLoading ...