Applicability of Laparoscopic Nephrectomy in the Treatment of Multicystic Dysplastic Kidney: Sorting Out Surgical Indication

Abstract

Introduction We evaluated the applicability of laparoscopic nephrectomy in the treatment of multicystic dysplastic kidney (MCDK) in children, including procedures performed by resident physicians or trainees in surgical urology. Methods We retrospectively evaluated the medical records of 20 children with MCDK who underwent laparoscopic nephrectomy over a six-year period. Data collected included gender, laterality of the affected kidney, age at the time of surgery, the largest diameter of the multicystic kidney and associated urological diagnoses, surgical, and postoperative data. All surgical procedures were performed transperitoneally. Results The mean age at the time of surgery was 46 months with a slight predominance of girls. The right side was the more affected side, and the average diameter of the affected kidney at the time of surgical excision was 5.8 cm. Other changes in the urinary tract were found in five children. The mean operative time was 133 minutes. On pathological examination, on average, the pieces measured 4.8 cm and weighed 18.1 g. There were no operative complications. The average length of hospital stay was 37.35 hours. Conclusion Laparoscopic nephrectomy was confirmed as an applicable treatment for MCDK. The technique was easy to perform, safe and efficient, even when performed by trainees in pediatric urology.

Multicystic dysplastic kidney with severe abdominal obstruction signs – case reports and management of children

“…The size of the affected kidney that should determine the need for a nephrectomy is discussed. Some Normal, ultrasound present involution of affected kidney clinics present the approach that nephrectomy is the best treatment for children if the size of a cluster is ≥ 5 cm in the first year of life or < 5 cm with no signs of regression during follow-up [19]. The currently offered laparoscopic surgery instead of open surgery is considered as a safe solution in justified cases.…”

“…The most common means of identification of MCDK is ultrasonography or another imaging method. However, there are rare cases when surgical intervention is required, and the diagnosis is made during the surgery itself [19].…”

“Watch and Wait” Strategy for Multicystic Dysplastic Kidney (MCDK): Status Survey of Perceptions, Attitudes, and Treatment Selection in Chinese Pediatric Urologists and Pediatric Surgeons

“…A "watch and wait" strategy is advocated according to recent natural history studies of MCDK (2). However, in some institutions, routine early surgical removal of these kidneys was advocated previously because of concerns about the potential for hypertension and malignancy (11,12). The appropriate management strategy for this anomaly is debated, and strategies are inconsistent within and between institutions.…”