ZHOU Hui xia,SU Ning,MA Li fei,et al.Which laparoscopic surgery approach is better for a nonfunctioning moiety in a duplex kidney in infants and children[J].Journal of Clinical Pediatric Surgery,,10():0.
Which laparoscopic surgery approach is better for a nonfunctioning moiety in a duplex kidney in infants and children
- Keywords:
- Laparoscopes; Nephrectomy; Child
- Abstract:
- Objective To report the outcomes of laparoscopic heminephrectomy for pediatric duplex kidney using retroperitoneal approach and modified transumbilical approach (MTA) and assess their clinical values. MethodsLaparoscopic heminephrectomies performed from Sept. 2006 to Sept. 2010 were retrospectively analyzed using retroperitoneal approach in 27 patients and using MTA in 18 patients, respectively. All patients were followed up for 1 to 24 months and accepted postoperative ultrasonography and 99mTcDTPA scintigraphy.ResultsAll operations were completed successfully without conversion into open surgery and need of intraoperative or postoperative blood transfusion. For retroperitoneal approach, the average operating time was 85minutes; the estimated average blood loss was 15mL; average hospital stay was 6 days. For MTA , the average operating time was 73minutes; the estimated average blood loss was 20mL; the average hospital stay was 5 days. loss of renal function or atrophy were not found in all patients by postoperative follow-up ultrasonography and 99mTcDTPA scintigraphy. There was no statistical difference in operating time, blood loss and postoperative hospital stay between two approaches (P>0.05).ConclusionsBoth retroperitoneal and MTA laparoscopic heminephrectomies are feasible, minimally invasive surgery. Retroperitoneal approach can directly target to kidney and has fewer complications caused by intestinal disturbances. By contrary, MTA has better cosmetic effect and better treatment for ureteral end, and is more suitable for infant under age one.
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Memo
作者单位：1， 北京军区总医院附属八一儿童医院泌尿外科（100700）；2， 首都医科大学附属北京儿童医院泌尿外科（100045）；3， 中国人民解放军总医院泌尿外科（100045），Email：snsunning@tom.com·