Retroperitoneoscopic Heminephrectomy in Duplex Kidney in Infants and Children: Results of a Multicentric Survey

Ciro Esposito, Go Miyano, Paolo Caione, Maria Escolino, Fabio Chiarenza, Giovanna Riccipetitoni, Atsuyuki Yamataka, Mariapina Cerulo, Antonio Savanelli, Alessandro Settimi, Jean Stephane Valla

Research output: Contribution to journalArticle

Abstract

Purpose: Retroperitoneoscopic partial nephrectomy (RPN) in children is considered a complex technique with limited diffusion among pediatric surgeons and urologists. We aimed to report the outcome of this technique in infants and children with duplex kidney in a 5-year retrospective multicentric international survey. Materials and Methods: Data on 50 children who underwent RPN (41 upper-pole nephrectomies and 9 lower-pole nephrectomies) were retrospectively collected in this six-institution survey. Median age at surgery was 3.3 years. There were 35 girls and 15 boys. The left side was affected in 28 patients, versus the right side in 22 patients. We assessed intraoperative and postoperative morbidity. Follow-up (median, 2.5 years; range, 12 months-5 years) was based on clinical controls and echo color Doppler renal ultrasound scans. Results: Median duration of surgery was 255 minutes. Surgery was always performed with the patient in a lateral position. Special hemostatic devices were used for dissection and parenchymal section in all centers. Three patients from two centers (6%) required conversion to open surgery. We recorded seven complications (six peritoneal perforations, one opening of the remaining calyxes) in the 50 cases. Re-operation rate was 0%. Average length of hospital stay was 4.1 days. Conclusions: Our survey shows that RPN remains a challenging procedure with a long learning curve, performed only in pediatric centers with huge experience in this field. In our survey operative time was longer than 4 hours. The complication rate remains high (7/50, or 14%), with complications classified as Grade II according to the Clavien-Dindo classification. They did not require further surgery, but they were associated with a prolonged hospital stay.

Original languageEnglish
Pages (from-to)864-869
Number of pages6
JournalJournal of Laparoendoscopic and Advanced Surgical Techniques
Volume25
Issue number10
DOIs
Publication statusPublished - Oct 1 2015

Fingerprint

Nephrectomy
Kidney
Length of Stay
Pediatrics
Conversion to Open Surgery
Doppler Ultrasonography
Learning Curve
Patient Rights
Hemostatics
Operative Time
Dissection
Color
Surveys and Questionnaires
Morbidity
Equipment and Supplies

ASJC Scopus subject areas

  • Surgery

Cite this

Retroperitoneoscopic Heminephrectomy in Duplex Kidney in Infants and Children : Results of a Multicentric Survey. / Esposito, Ciro; Miyano, Go; Caione, Paolo; Escolino, Maria; Chiarenza, Fabio; Riccipetitoni, Giovanna; Yamataka, Atsuyuki; Cerulo, Mariapina; Savanelli, Antonio; Settimi, Alessandro; Valla, Jean Stephane.

In: Journal of Laparoendoscopic and Advanced Surgical Techniques, Vol. 25, No. 10, 01.10.2015, p. 864-869.

Research output: Contribution to journalArticle

Esposito, C, Miyano, G, Caione, P, Escolino, M, Chiarenza, F, Riccipetitoni, G, Yamataka, A, Cerulo, M, Savanelli, A, Settimi, A & Valla, JS 2015, 'Retroperitoneoscopic Heminephrectomy in Duplex Kidney in Infants and Children: Results of a Multicentric Survey', Journal of Laparoendoscopic and Advanced Surgical Techniques, vol. 25, no. 10, pp. 864-869. https://doi.org/10.1089/lap.2014.0654
Esposito, Ciro ; Miyano, Go ; Caione, Paolo ; Escolino, Maria ; Chiarenza, Fabio ; Riccipetitoni, Giovanna ; Yamataka, Atsuyuki ; Cerulo, Mariapina ; Savanelli, Antonio ; Settimi, Alessandro ; Valla, Jean Stephane. / Retroperitoneoscopic Heminephrectomy in Duplex Kidney in Infants and Children : Results of a Multicentric Survey. In: Journal of Laparoendoscopic and Advanced Surgical Techniques. 2015 ; Vol. 25, No. 10. pp. 864-869.
@article{cb8ed16b48c44ab2b5a4556fdc71b26f,
title = "Retroperitoneoscopic Heminephrectomy in Duplex Kidney in Infants and Children: Results of a Multicentric Survey",
abstract = "Purpose: Retroperitoneoscopic partial nephrectomy (RPN) in children is considered a complex technique with limited diffusion among pediatric surgeons and urologists. We aimed to report the outcome of this technique in infants and children with duplex kidney in a 5-year retrospective multicentric international survey. Materials and Methods: Data on 50 children who underwent RPN (41 upper-pole nephrectomies and 9 lower-pole nephrectomies) were retrospectively collected in this six-institution survey. Median age at surgery was 3.3 years. There were 35 girls and 15 boys. The left side was affected in 28 patients, versus the right side in 22 patients. We assessed intraoperative and postoperative morbidity. Follow-up (median, 2.5 years; range, 12 months-5 years) was based on clinical controls and echo color Doppler renal ultrasound scans. Results: Median duration of surgery was 255 minutes. Surgery was always performed with the patient in a lateral position. Special hemostatic devices were used for dissection and parenchymal section in all centers. Three patients from two centers (6{\%}) required conversion to open surgery. We recorded seven complications (six peritoneal perforations, one opening of the remaining calyxes) in the 50 cases. Re-operation rate was 0{\%}. Average length of hospital stay was 4.1 days. Conclusions: Our survey shows that RPN remains a challenging procedure with a long learning curve, performed only in pediatric centers with huge experience in this field. In our survey operative time was longer than 4 hours. The complication rate remains high (7/50, or 14{\%}), with complications classified as Grade II according to the Clavien-Dindo classification. They did not require further surgery, but they were associated with a prolonged hospital stay.",
author = "Ciro Esposito and Go Miyano and Paolo Caione and Maria Escolino and Fabio Chiarenza and Giovanna Riccipetitoni and Atsuyuki Yamataka and Mariapina Cerulo and Antonio Savanelli and Alessandro Settimi and Valla, {Jean Stephane}",
year = "2015",
month = "10",
day = "1",
doi = "10.1089/lap.2014.0654",
language = "English",
volume = "25",
pages = "864--869",
journal = "Journal of Laparoendoscopic and Advanced Surgical Techniques - Part A",
issn = "1092-6429",
publisher = "Mary Ann Liebert Inc.",
number = "10",

}

TY - JOUR

T1 - Retroperitoneoscopic Heminephrectomy in Duplex Kidney in Infants and Children

T2 - Results of a Multicentric Survey

AU - Esposito, Ciro

AU - Miyano, Go

AU - Caione, Paolo

AU - Escolino, Maria

AU - Chiarenza, Fabio

AU - Riccipetitoni, Giovanna

AU - Yamataka, Atsuyuki

AU - Cerulo, Mariapina

AU - Savanelli, Antonio

AU - Settimi, Alessandro

AU - Valla, Jean Stephane

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Purpose: Retroperitoneoscopic partial nephrectomy (RPN) in children is considered a complex technique with limited diffusion among pediatric surgeons and urologists. We aimed to report the outcome of this technique in infants and children with duplex kidney in a 5-year retrospective multicentric international survey. Materials and Methods: Data on 50 children who underwent RPN (41 upper-pole nephrectomies and 9 lower-pole nephrectomies) were retrospectively collected in this six-institution survey. Median age at surgery was 3.3 years. There were 35 girls and 15 boys. The left side was affected in 28 patients, versus the right side in 22 patients. We assessed intraoperative and postoperative morbidity. Follow-up (median, 2.5 years; range, 12 months-5 years) was based on clinical controls and echo color Doppler renal ultrasound scans. Results: Median duration of surgery was 255 minutes. Surgery was always performed with the patient in a lateral position. Special hemostatic devices were used for dissection and parenchymal section in all centers. Three patients from two centers (6%) required conversion to open surgery. We recorded seven complications (six peritoneal perforations, one opening of the remaining calyxes) in the 50 cases. Re-operation rate was 0%. Average length of hospital stay was 4.1 days. Conclusions: Our survey shows that RPN remains a challenging procedure with a long learning curve, performed only in pediatric centers with huge experience in this field. In our survey operative time was longer than 4 hours. The complication rate remains high (7/50, or 14%), with complications classified as Grade II according to the Clavien-Dindo classification. They did not require further surgery, but they were associated with a prolonged hospital stay.

AB - Purpose: Retroperitoneoscopic partial nephrectomy (RPN) in children is considered a complex technique with limited diffusion among pediatric surgeons and urologists. We aimed to report the outcome of this technique in infants and children with duplex kidney in a 5-year retrospective multicentric international survey. Materials and Methods: Data on 50 children who underwent RPN (41 upper-pole nephrectomies and 9 lower-pole nephrectomies) were retrospectively collected in this six-institution survey. Median age at surgery was 3.3 years. There were 35 girls and 15 boys. The left side was affected in 28 patients, versus the right side in 22 patients. We assessed intraoperative and postoperative morbidity. Follow-up (median, 2.5 years; range, 12 months-5 years) was based on clinical controls and echo color Doppler renal ultrasound scans. Results: Median duration of surgery was 255 minutes. Surgery was always performed with the patient in a lateral position. Special hemostatic devices were used for dissection and parenchymal section in all centers. Three patients from two centers (6%) required conversion to open surgery. We recorded seven complications (six peritoneal perforations, one opening of the remaining calyxes) in the 50 cases. Re-operation rate was 0%. Average length of hospital stay was 4.1 days. Conclusions: Our survey shows that RPN remains a challenging procedure with a long learning curve, performed only in pediatric centers with huge experience in this field. In our survey operative time was longer than 4 hours. The complication rate remains high (7/50, or 14%), with complications classified as Grade II according to the Clavien-Dindo classification. They did not require further surgery, but they were associated with a prolonged hospital stay.

UR - http://www.scopus.com/inward/record.url?scp=84945566025&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84945566025&partnerID=8YFLogxK

U2 - 10.1089/lap.2014.0654

DO - 10.1089/lap.2014.0654

M3 - Article

C2 - 26390256

AN - SCOPUS:84945566025

VL - 25

SP - 864

EP - 869

JO - Journal of Laparoendoscopic and Advanced Surgical Techniques - Part A

JF - Journal of Laparoendoscopic and Advanced Surgical Techniques - Part A

SN - 1092-6429

IS - 10

ER -