Marietti Sarah, Holmes Nicholas, Chiang George
LESS Bilateral Nephrectomy in Children, Division of Urology and Rady Children's Hospital, University of California, San Diego, CA, USA.
Pediatr Transplant. 2011 Jun;15(4):396-9. doi: 10.1111/j.1399-3046.2011.01504.x.
End-stage renal failure management in children may require bilateral kidney removal prior to transplantation secondary to recurrent urinary tract infections, renin-dependent hypertension, vesicoureteral reflux, proteinuria, risk of malignancy (Denys-Drash), or high output renal failure. Conventional laparoscopy or open nephrectomy has been employed to date. However, we present our method of bilateral nephrectomy in four patients via the SILS Covidien © system. Patient age ranged from 18 months to 18 years. Operative time ranged from 308 to 370 minutes. Estimated blood loss was minimal, all cases were completed via the single incision and no cases were converted to open. Laparoendoscopic single-site bilateral nephrectomy is safe and feasible in children and well-suited for the pre-transplant population.
儿童终末期肾衰竭的管理可能需要在移植前进行双侧肾脏切除，原因包括复发性尿路感染、肾素依赖性高血压、膀胱输尿管反流、蛋白尿、恶性肿瘤风险（丹尼斯-德拉什综合征）或高输出量肾衰竭。迄今为止，一直采用传统的腹腔镜手术或开放肾切除术。然而，我们介绍了通过SILS Covidien ©系统对4例患者进行双侧肾切除术的方法。患者年龄从18个月至18岁不等。手术时间从308分钟至370分钟不等。估计失血量极少，所有病例均通过单一切口完成，无一例转为开放手术。腹腔镜单部位双侧肾切除术在儿童中是安全可行的，非常适合移植前人群。
