Laparoscopie Nephrectomy and Heminephrectomy in Pediatric Patients / 대한비뇨기과학회지

ABSTRACT

PURPOSE: Many operative procedures in pediatric urology can be performed by laparoscopy. We report our experiences with laparoscopic nephrectomy and heminephrectomy and evaluate its usefulness in pediatric patients. MATERIALS AND METHODS: Between August 1996 and December 1997, a total of 10 children aged between 2 and 9 years underwent laparoscopic renal surgeries in Seoul National University Hospital. The laparoscopic nephrectomy (including nephroureterectomy) was performed in 8 patients(4 multicystic kidneys, 2 dysplastic kidneys associated with ectopic ureter, 2 nonfunctioning kidneys associated with vesicoureteral reflux), and heminephrectomy was done in the other 2 patients(duplex kidney). RESULTS: All laparoscopic nephrectomies were completed as planned. Operative time ranged 120 to 300 minutes(mean 180 minutes) and there were no intraoperative or postoperative complications. Oral intake and mobilization were started from postoperative one day and the patients had hospitalized for an average 3.6 days. Laparoscopic heminephrectomy in one patient was performed successfully. Total operative time recorded 240 minutes and there were no intraoperative or postoperative complications. But the other patient experienced bleeding from the injured upper pole artery and subsequent conversion to an open surgery was needed. CONCLUSIONS: Laparoscopic nephrectomy in children is feasible as its morbidity and complication rate are low. Laparoscopic heminephrectomy is thonght to be a technically demanding procedure, requiring more experience.