Artículos de revistas
Laparoscopic Upper-pole Nephroureterectomy In Infants
Registro en:
International Braz J Urol. , v. 33, n. 1, p. 87 - 91, 2007.
16775538
2-s2.0-33947412292
Autor
Miranda M.L.
Oliveira-Filho A.G.
Carvalho P.T.
Ungersbock E.
Olimpio H.
Bustorff-Silva J.M.
Institución
Resumen
Objective: Report the results of laparoscopic upper-pole nephroureterectomy in infants. Materials and Methods: Six consecutive infants underwent 7 laparoscopic upper-pole nephroureterectomy. Pre and post-operative evaluation included renal sonography, voiding cystourethrogram and renal scintigraphy. All infants showed upper-pole exclusion. Surgery was performed through a transperitoneal approach with full flank position in all infants. Three or 4 ports were used according to the necessity of retracting the liver. The distal ureter was ligated close to the bladder whenever reflux was present and the dysplastic upper-pole was divided with the help of an electrocautery. Data regarding operative time, postoperative use of analgesics, time to resume oral feeding, hospital stay and tubular function were collected and analyzed. Results: All procedures were concluded as planned. Mean operative time was 135 min. One patient underwent staged bilateral upper-pole nephrectomy. There were no complications and the postoperative hospital stay was 48 hours in 5 procedures and 24 hours in 2 procedures. Pain medication was required only in the first day. Renal tubular function showed improvement in half of the cases. Conclusion: Laparoscopic partial nephrectomy is a safe and feasible procedure in infants. Due to the magnification provided by the lenses, a better vision of the structures is achieved, facilitating selective dissection of vascular upper-pole, renal parenchyma and distal ureter. This approach is less damaging to the lower pole, and is associated to low morbidity and a short hospital stay. 33 1 87 91 Peters, C.A., Laparoscopic and robotic approach to genitourinary anomalies in children (2004) Urol Clin North Am, 31, pp. 595-605 Robinson, B.C., Snow, B.W., Cartwright, P.C., De Vries, C.R., Hamilton, B.D., Anderson, J.B., Comparison of laparoscopic versus open partial nephrectomy in a pediatric series (2003) J Urol, 169, pp. 638-640 Steyaert, H., Valla, J.S., Minimally invasive urologic surgery in children: An overview of what can be done (2005) Eur J Pediatr Surg, 15, pp. 307-313 Koyle, M.A., Woo, H.H., Kavoussi, L.R., Laparoscopic nephrectomy in the first year of life (1993) J Pediatr Surg, 28, pp. 693-695 Valla, J.S., Breaud, J., Carfagna, L., Tursini, S., Steyaert, H., Treatment of ureterocele on duplex ureter: Upper pole nephrectomy by retroperitoneoscopy in children based on a series of 24 cases (2003) Eur Urol, 43, pp. 426-429 Jordan, G.H., Winslow, B.H., Laparoendoscopic upper pole partial nephrectomy with ureterectomy (1993) J Urol, 150, pp. 940-943 Horowitz, M., Shah, S.M., Ferzli, G., Syad, P.I., Glassberg, K.I., Laparoscopic partial upper pole nephrectomy in infants and children (2001) BJU Int, 87, pp. 514-516 Gill, I.S., Delworth, M.G., Munch, L.C., Laparoscopic retroperitoneal partial nephrectomy (1994) J Urol, 152, pp. 1539-1542 Borzi, P.A., A comparison of the lateral and posterior retroperitoneoscopic approach for complete and partial nephroureterectomy in children (2001) BJU Int, 87, pp. 517-520 Desgrandchamps, F., Gossot, D., Jabbour, M.E., Meria, P., Teillac, P., Le Duc, A., A 3 trocar technique for transperitoneal laparoscopic nephrectomy (1999) J Urol, 161, pp. 1530-1532 Hulbert, W.C., Rabinowitz, R., Prenatal diagnosis of duplex system hydronephrosis: Effect on renal salvage (1998) Urology, 51, pp. 23-26 El-Ghoneimi, A., Farhat, W., Bolduc, S., Bagli, D., McLorie, G., Khoury, A., Retroperitoneal laparoscopic vs open partial nephroureterectomy in children (2003) BJU Int, 91, pp. 532-535 Jednak, R., Kryger, J.V., Barthold, J.S., Gonzalez, R., A simplified technique of upper pole heminephrectomy for duplex kidney (2000) J Urol, 164, pp. 1326-1328 Borzi, P.A., Yeung, C.K., Selective approach for transperitoneal and extraperitoneal endoscopic nephrectomy in children (2004) J Urol, 171, pp. 814-816 Guillonneau, B., Ballanger, P., Lugagne, P.M., Valla, J.S., Vallancien, G., Laparoscopic versus lumboscopic nephrectomy (1996) Eur Urol, 29, pp. 288-291 Janetschek, G., Seibold, J., Radmayr, C., Bartsch, G., Laparoscopic heminephroureterectomy in pediatric patients (1997) J Urol, 158, pp. 1928-1930