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- Title
Outcome of Laparoscopic Upper-Pole Nephrectomy in Children with Duplex Systems.
- Authors
Francisco T Dénes; Alexandre Danilovic; Miguel Srougi
- Abstract
Purpose To report the results of laparoscopic upper-pole nephrectomy for children with duplex systems.Patients and Methods Nineteen laparoscopic transperitoneal upper-pole nephrectomies (11 on the left and 8 on the right) were performed in 17 patients with complete pyelocaliceal duplication. Postoperative follow-up consisted of clinical evaluation, as well as functional and image studies of the remaining lower unit with renal ultrasonography, 99mTc-DMSA, voiding cystourethrography, and urography or enhanced helical CT, according to individual needs.Results The mean operative time was 147 minutes (range 110–180 minutes). There were no conversions to open surgery and no transfusions. The mean follow-up was 57.1 months. Lower-unit function was preserved after 18 procedures (94.7). Transient asymptomatic urinary-tract infection was observed in 5 of 17 children (29.4). Vesicoureteral reflux resolved in 3 of 4 children (75) and improved in the other, and all 7 ureteroceles associated with the resected upper unit were decompressed, although two (28.6) remained present asymptomatically by ultrasonography. Empyema of the lower-ureteral stump was a late complication in 3 of the 19 duplex systems.Conclusion Laparoscopic transperitoneal polar nephrectomy in children with pyelocaliceal duplication is feasible and presents all the advantages of minimally invasive procedures. It has good long-term results, as judged by preservation of the lower unit, regression of ureterocele and reflux, and reduction in the incidence of infection.
- Subjects
KIDNEY surgery; LAPAROSCOPIC surgery; VESICO-ureteral reflux; URINARY tract infections
- Publication
Journal of Endourology, 2007, Vol 21, Issue 2, p162
- ISSN
0892-7790
- Publication type
Article