Laparoscopic nephrectomy for renal diseases in children: is there a learning curve?

Ku, Ja Hyeon; Yeo, Woon Geol; Kim, Hyeon Hoe; Choi, Hwang

doi:10.1016/j.jpedsurg.2005.03.052

Cited by 19 publications

(10 citation statements)

References 19 publications

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“…Studies have shown that mean operative times decrease significantly after about ten LNs. [89] Our operative time and conversion rates also fell significantly after the first ten cases. With experience, other procedures can be performed simultaneously without much increase in operative time.…”

Section: Discussionmentioning

confidence: 79%

Laparoscopic nephrectomy in children for benign conditions: indications and outcome

Menon

Handu

Rao

et al. 2014

J Indian Assoc Pediatr Surg

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Aim:To analyze the indications and outcome of laparoscopic nephrectomy for benign non-functioning kidneys in children.Materials and Methods:The data of all patients operated over a 10 year period was retrospectively analyzed.Results:There were 56 children, aged 4 months to 12 years with a male: female ratio of 2.3:1. The most common presentation in boys and girls was urinary tract infection (UTI) (61.5% and 47.05% respectively). Incontinence due to ectopic ureter was a close second in girls (41.17%). The most common underlying conditions were vesico-ureteric reflux (42.85%) and multicystic dysplastic kidney (23.2%). There were 6 nephrectomies, 4 heminephroureterectomies and the remaining nephroureterectomies. All children tolerated the surgery well. One patient underwent a concomitant cholecystectomy. The post-operative problems encountered were UTI (1), urine retention (1), pyonephrosis in the opposite kidney and development of contra-lateral reflux (1). All others had resolution of pre-operative symptoms with good cosmesis.Conclusions:As per available literature, this appears to be the largest Indian series of pediatric laparoscopic nephrectomies for benign non-functioning kidneys. Laparoscopic approach gives excellent results provided pre-operative investigations rule out other causes for the symptoms with which the patient presents. Often it is not the kidney but the dilated dysplastic ureter which is the seat of stasis and infection or pain and therefore should be completely removed.

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Section: Discussionmentioning

confidence: 79%

Laparoscopic nephrectomy in children for benign conditions: indications and outcome

Menon

Handu

Rao

et al. 2014

J Indian Assoc Pediatr Surg

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“…The laparoscopicassisted approach avoided the need for a more extended nephrectomy incision or even a second iliac cut, which is often required in these cases. [34] Despite the operative…”

Section: Discussionmentioning

confidence: 99%

Laparascopic-assisted nephroureterectomy for shaped urolithiasis and xanthogranulomatous pyelonephritis: Case report and review of literature

Pastore

Niglio

Basile

et al. 2013

Afr J Paediatr Surg

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We report a case of xanthogranulomatous pyelonephritis (XGP) complicated by shaped urolithiasis, severe hydroureteronephrosis and kidney exclusion treated by laparoscopic-assisted nephroureterectomy. A 9 year-old boy was referred to us for recurrent episodes of urinary tract infection, abdominal pain and severe hydronephrosis. Abdominal CT and a Tc-99m MAG3 scan showed a non-functioning obstructed kidney with shaped urolithiasis of the distal ureter. XGP was suspected, and nephroureterectomy was performed by laparoscopic distal ureterectomy and open extraperitoneal nephrectomy. This technique avoided the need for a more extended nephrectomy incision or even a second iliac incision. It also ensured complete excision of the distal ureter with minimal risk of developing the ureteral stump syndrome, which sometimes follows nephroureterectomy. We believe that laparoscopic-assisted nephroureterectomy may be a suitable technique in those cases of difficult nephrectomy where a ureteral stump syndrome is likely to develop.

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“…Group B consisted of 61 patients older than 12 months and weighing more than 10 kg at surgery. Because surgical outcomes are reported to be significantly improved after 10 to 20 cases of laparoscopic ablative renal surgery, [12][13][14] we controlled for the learning curve by classifying all consecutive cases in groups of 10.…”

Section: Patientsmentioning

confidence: 99%

Feasibility and Safety of Laparoscopic Ablative Renal Surgery in Infants: Comparative Study with Children

et al. 2012

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Laparoscopic nephrectomy for renal diseases in children: is there a learning curve?

Cited by 19 publications

References 19 publications

Laparoscopic nephrectomy in children for benign conditions: indications and outcome

Laparoscopic nephrectomy in children for benign conditions: indications and outcome

Laparascopic-assisted nephroureterectomy for shaped urolithiasis and xanthogranulomatous pyelonephritis: Case report and review of literature

Feasibility and Safety of Laparoscopic Ablative Renal Surgery in Infants: Comparative Study with Children

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