Department of Pediatric Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India.
Department of Anaesthesiology, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India.
J Pediatr Urol. 2014 Dec;10(6):1122-5. doi: 10.1016/j.jpurol.2014.05.001. Epub 2014 Jun 2.
The objective of this study was to assess the feasibility and challenges in a lumbotomy approach for performing upper urinary tract surgeries in adolescent children.
Fifty-five adolescent children underwent various upper urinary tract surgeries from 2000 to 2012. In all patients, the kidneys and ureters were approached via a lumbotomy incision. The patients' characteristics were analysed from the hospital charts. Intraoperative and postoperative details were gathered from individual case files. Data were collected regarding: age, weight, gender, diagnosis, surgical procedure, anaesthetic details, any intraoperative problems encountered, postoperative pain, time to oral feed, length of hospitalisation and any complications.
The median age at surgery was 14 years (range 10-19). There were 42 boys and 13 girls. Median weight was 41 kg (range 28-52 kg). Surgeries performed were pyeloplasty, pyelolithotomy, nephroureterectomy and heminephrectomy. Mean duration of surgery was 80 min (range 60-130 min) with no special anaesthetic requirements. No intraoperative problems were encountered. In all patients, postoperative stay was uneventful with minimal analgesic requirements and oral feeding was started the very next day. There were no incision-related complications.
A lumbotomy incision is technically easy and safe, even in adolescent children, as an approach for upper urinary-tract surgeries.
本研究旨在评估经腰部切口施行青少年上尿路手术的可行性和面临的挑战。
2000 年至 2012 年期间，55 例青少年患儿接受了各种上尿路手术。所有患者均经腰部切口入路处理肾脏和输尿管。从病历中分析患者的特征。从个案档案中收集术中及术后的详细信息。数据收集内容包括：年龄、体重、性别、诊断、手术过程、麻醉细节、术中遇到的任何问题、术后疼痛、开始口服喂养的时间、住院时间以及任何并发症。
手术时的中位年龄为 14 岁（范围 10-19 岁）。其中男 42 例，女 13 例。中位体重为 41kg（范围 28-52kg）。施行的手术包括肾盂成形术、肾盂切开取石术、肾输尿管切除术和半肾切除术。手术平均持续 80min（范围 60-130min），无特殊麻醉要求。术中无任何问题发生。所有患者术后恢复顺利，仅需最低限度的镇痛，术后次日即可开始经口进食。无切口相关并发症。
对于上尿路手术，腰部切口是一种技术上简单且安全的入路方法，即使是在青少年患者中也是如此。
