Analysis of the late outcome of laparoscopic heminephrectomy in children with duplex kidneys

Abstract

magnetic resonance imaging with urography, and nuclear scintigraphy. After surgery patients were evaluated using ultrasonography and nuclear scintigraphy, and by voiding cysto-urethrography if there was a refluxing ureter.

Outcomes in Pediatric Robot-Assisted Laparoscopic Heminephrectomy Compared with Contemporary Open and Laparoscopic Series

“…Several theories have been proposed to explain the cause, including ischemic injury or vasospasm resulting in decreased function of the remnant kidney. 13,14 Moreover, the poorly functioning moiety is likely to contribute to some, albeit small, percentage of the total renal function of the preoperative kidney, and removal may result in a loss of kidney function. In addition, the area of interest on nuclear renography is often drawn arbitrarily with no distinct demarcation of the moieties.…”

Transperitoneal laparoscopic heminephroureterectomy in the pediatric population: A single-centre experience using a sealing device

“…On the other hand some other authors recommended the insertion of a stent to the ureter of the pole of the affected kidney as it made it easier to distinguish it from the normal ureter during laparoscopy. 11 Following the same idea, in our cases, we inserted through cystoscopy a ureteral catheter to the ureter of the pole of the normal kidney (not of the affected kidney).…”

“…In the study of Valla et al, the rate of the conversion to open surgery was 12.5%. 11 In our study group, all patients were operated with the transperitoneal LHNU. None of our patients had severe complications such as injury to the normal renal pole, postoperative ileus or minor complications such as urinary leakage or fever.…”

“…LHNU is usually carried out with 3 or 4 ports. 2,11,13,14 In the LHNU operations of the right kidney, liver retraction and the use of the 3 rd working port to enable colon retraction in children over 3 kg was recommended. 8 Taking the differences of both left and right sides into consideration, it is useful to insert the 4th trocar on the right side for the liver retraction and for better exposure of the upper side of the kidney.…”

“…7 The average duration of the LHNU, which was 222 minutes (180-330 minutes) in the last 20 years, 13 LHNU has the advantages of shorter hospitalization time, lower morbidity, lower complication rates and more satisfying cosmetic results compared with open surgery. 2,7,8,11,13 In the studies conducted with age-matched cohort groups, it was found out that the hospitalization time was shorter in LHNU carried out with transperitoneal or retroperitoneal approach compared with open surgery. 11 In their study, Boris et al noticed the significantly different average hospitalization times between open surgery and LHNU (2.7 and 5.1 days respectively).…”