Division of Pediatric Urology, Children's Hospital Los Angeles, Los Angeles, California 90027, USA.
Urology. 2010 Dec;76(6):1457-61. doi: 10.1016/j.urology.2010.06.066. Epub 2010 Oct 23.
To present our initial clinical series of laparoendoscopic single-site (LESS) nephrectomy using an umbilical incision in children ranging from infants to adolescents. Laparoscopic surgery in pediatric urology is increasingly being performed for many intra-abdominal ablative procedures, such as nephrectomy for poorly functioning kidneys. We have previously reported our initial experience with LESS surgery in the adult population.
A total of 11 pediatric patients (age range 0.1-16.2 years, mean 5.7) underwent LESS nephrectomy using an umbilical incision. The perioperative clinical parameters were reviewed retrospectively.
The 11 LESS pediatric nephrectomies were technically successful without conversion to conventional laparoscopy or open surgery. An accessory port was used in 5 of the cases early in the clinical series. Of the 11 patients, 2 were infants, aged 39 days and 3.5 months. The mean operative time was 139 minutes (range 85-205), and the mean hospital stay was 1.5 days (range 1.0-2.1). Complications included delayed hydrocele formation in 2 male patients.
The results of our study have shown that LESS nephrectomy using a single umbilical incision in pediatric patients is technically feasible with good outcomes. Additional studies are needed to evaluate the expected benefits of this novel technique. Also, miniaturization of currently available equipment is needed to adapt to the small working spaces available in the pediatric patient.
介绍我们在儿童中使用脐部切口进行经脐腹腔镜单部位（LESS）肾切除术的初步临床系列。小儿泌尿外科的腹腔镜手术越来越多地用于许多腹腔内消融手术，如用于功能不良肾脏的肾切除术。我们之前已经报告了我们在成人人群中进行 LESS 手术的初步经验。
共有 11 名儿科患者（年龄 0.1-16.2 岁，平均 5.7 岁）接受了脐部切口的 LESS 肾切除术。回顾性审查围手术期临床参数。
11 例 LESS 小儿肾切除术技术上均成功，无需转为传统腹腔镜或开放手术。在临床系列的早期，有 5 例使用了辅助端口。11 名患者中有 2 名是婴儿，年龄分别为 39 天和 3.5 个月。平均手术时间为 139 分钟（范围 85-205），平均住院时间为 1.5 天（范围 1.0-2.1）。并发症包括 2 名男性患者延迟性鞘膜积液形成。
我们的研究结果表明，在小儿患者中使用单一切口经脐腹腔镜肾切除术在技术上是可行的，并且具有良好的效果。需要进一步的研究来评估这项新技术的预期益处。此外，需要对现有设备进行小型化，以适应小儿患者可用的小工作空间。
