[Laparoscopic and open heminephrectomy in children: results comparison].

UNLABELLED: Objectives. To compare the results of laparoscopic and open heminephrectomy for kidneys duplication in children. Materials and methods. 42 patients underwent laparoscopic heminephrectomy and 20 patients underwent open heminephrectomy for non-functioning kidney moiety. Transperitoneal access with 3-4 trocars was used in the first group. Retrospective analysis of demographic, intra- and postoperative parameters, developed complications was performed. RESULTS: The mean operative duration was 127 minutes (90-205) and 120 minutes (100-219) in laparoscopic and open surgery groups, respectively. There were not intraoperative complications and need for conversion in laparoscopic group. Two children required additional surgery for perirenal cyst and ureteric stump inflammation. Hemotransfusion after open surgery was performed in 2 cases. Complications included pleural sine laceration and complete function loss of remaining moiety. The mean hospital stay was 7.2 days (5-12) and 11.5 days (8-17) in laparoscopic and open surgery groups, respectively. CONCLUSIONS: Laparoscopic transperitoneal heminephrectomy can be successfully used in children. Duration of laparoscopic and open interventions is comparable. But hospital stay is less in case of laparoscopic interventions.

[Laparoscopic heminephrouretherectomy in children with double kidney].

The article revises the first experienced of laparoscopic geminephrouretherectomy in our country. 5 children aged 3-14 years were operated on. In 1 case of double ureter the laparoscopic ureterectomy was performed, the rest 4 patients experienced geminephrouretherectomy (2 left and 2 right).The operative time was 100-180 minutes. There were no intra- and postoperative complications. All children were discharged on 6-12th postoperative day. Follow-up examination verified perfect cosmetic and functional results.

[Treatment of urethral fistulas in children with application of allogenic fibroblasts].

The study was aimed at upgrading the results of conservative treatment of children with urethral fistulas using methods of tissue engineering. A total of 126 operations for closure of urethral fistulas (UF) were made from 1986 to 2007. The patients were divided into four groups. A conservative therapy was given to 25 children of group 1 aged 5-15 years. Group 2 of 60 patients were operated according to Smith. 39 children entered group 3. They were treated conservatively with application of allogenic fibroblasts. In 1 child UF was closed by a combined method when application of fibroblasts was made upon the sutures. Use of cell technologies for closure of urethral fistulas demonstrates high efficacy of the method for conservative management of long urethral fistulas of a small diameter. Application of allogenic fibroblasts has definite indications and contraindications. In some cases it cannot be used for correction of postoperative complications. Adequate preoperative examination of the patients should be made to formulate optimal therapeutic policy.

[Use of a laryngeal mask during combined regional anesthesia in children].

For intraoperative anesthesia, the authors applied central regional blocks. A laryngeal mask was used to maintain free airways patency. The purpose of this study was to provide evidence for the effectiveness of a laryngeal mask used under combined regional anesthesia and to establish whether the mask could be employed for artificial ventilation during laparoscopy in children.