Aydogdu Ibrahim, Silay Mesrur Selcuk
Bezmialem Vakif University, Faculty of Medicine, Department of Pediatric Surgery.
Istanbul Medeniyet University, Faculty of Medicine, Department of Pediatric Urology; Istanbul, Turkey.
Can Urol Assoc J. 2018 Sep;12(9):E409-E414. doi: 10.5489/cuaj.4992.
We sought to report the outcomes of transperitoneal laparoscopic heminephroureterectomy (LHNU) in pediatric population and to describe the technical details of this minimally invasive surgery.
Seventeen pediatric patients (18 renal units), who had consecutive transperitoneal LHNU in our department between January 2012 and July 2017 were included in the study. In all patients, diagnostic cystoscopy and retrograde pyelography were carried out immediately before the operation. A catheter was inserted in the unaffected ureter and fixed. LHNU with a transperitoneal approach was carried out in all patients with the aid of LigaSure. After removal of the specimen, the intervention was finalized with the insertion of a drain. All intraoperative and postoperative data of the patients were recorded prospectively.
The average age of the patients was 55.9±35.8 months (range 8-121). The average duration of the operations was 121.7±24.0 minutes (range 100-200). The average hospitalization time was 1.6±0.4 days (range 1-2). No intraoperative complication occurred in our patients. The average followup period was 29.1±13.4 months (range 4-48). During the followup period, no complications were observed except one patient who had pyelonephritis within the first month of surgery.
Transperitoneal LHNU is a minimally invasive method that can be used safely in pediatric patients. Using a standardized technique during the procedure is critical to increase the success and decrease the complication rates.
我们旨在报告经腹腹腔镜半肾输尿管切除术(LHNU)在儿科患者中的治疗结果,并描述这种微创手术的技术细节。
本研究纳入了2012年1月至2017年7月在我科连续接受经腹LHNU手术的17例儿科患者(18个肾单位)。所有患者在手术前均立即进行了诊断性膀胱镜检查和逆行肾盂造影。在未受影响的输尿管中插入导管并固定。所有患者均在LigaSure辅助下采用经腹途径进行LHNU手术。切除标本后,通过插入引流管完成干预。前瞻性记录患者的所有术中及术后数据。
患者的平均年龄为55.9±35.8个月(范围8 - 121个月)。手术平均时长为121.7±24.0分钟(范围100 - 200分钟)。平均住院时间为1.6±0.4天(范围1 - 2天)。我们的患者术中未发生并发症。平均随访期为29.1±13.4个月(范围4 - 48个月)。在随访期间,除1例患者在术后第一个月发生肾盂肾炎外,未观察到其他并发症。
经腹LHNU是一种可安全用于儿科患者的微创方法。手术过程中采用标准化技术对于提高成功率和降低并发症发生率至关重要。