Abstract
Objective
Despite increasing acceptance of laparoscopy in pediatric urology, few published data
are available on laparoscopic heminephroureterectomy in patients with duplex kidney
anomalies. In the present study, we report our own experiences with this technique.
Patients and methods
From August 2003 to January 2006, five laparoscopic heminephroureterectomies were
performed in four girls with a mean age of 41 (9–67) months. In all cases, a non-functioning
upper pole with an obstructive (n=4) or refluxing (n=1) megaureter was found. The upper pole was resected laparoscopically en bloc with the megaureter using three to four trocars.
Results
Mean follow-up was 42.4 (±7.9) months. All procedures were performed successfully
without conversion to open surgery with a mean operative time of 190 (170–210) min. Blood loss was minimal and no intraoperative complications occurred. Despite
chronic inflammation in the resected specimens, the patients showed no clinical signs
of infection postoperatively. The average length of hospital stay was 5.6 (4–7) days.
All patients were followed using duplex sonography.
Conclusions
These data demonstrate that, even in infants, laparoscopic heminephroureterectomy
is feasible and associated with minimal morbidity, a better cosmetic result and a
shorter hospital stay compared to open surgery. The main disadvantage of the laparoscopic
approach is a longer operative time. Laparoscopic heminephroureterectomy is a technically
demanding procedure and should be performed only in specialized centers.
Keywords
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Article info
Publication history
Published online: June 13, 2008
Accepted:
March 5,
2008
Received:
August 27,
2007
Identification
Copyright
© 2008 Published by Elsevier Inc.
