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 language | English |
|---|---|
| Pages (from-to) | 864-869 |
| Number of pages | 6 |
| Journal | Journal of Laparoendoscopic and Advanced Surgical Techniques |
| Volume | 25 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - Oct 1 2015 |
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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 journal › Article
}
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 -