Laparoscopic nephrectomy in children.
BACKGROUND
Laparoscopic nephrectomy in the adult population is reported with increased frequency. We present our initial experience with laparoscopic nephrectomy in children.


METHODS
Over a 2-year period, 11 nephrectomies were performed in nine children aged 16 months to 16 years (mean, 6.5 years). All patients were referred due to complications of a nonfunctioning kidney. Seven patients had recurrent urinary tract infections, and two had refractory hypertension. Two patients underwent bilateral laparoscopic nephrectomy. The operation was performed using four access ports measuring 3.5 to 10 mm.


RESULTS
All kidneys were removed successfully using a laparoscopic technique. The average length of the operation was 163 min per kidney (range, 90-420). The estimated blood loss was <10-150 ml (mean, 45). No patient required transfusion. Seven patients were discharged home by postoperative day 2. The two patients with the longest operating times were discharged home on postoperative days 4 and 5 due to delay in return of bowel function. Narcotic use was minimal, and all patients enjoyed a rapid return to full activity.


CONCLUSIONS
Laparoscopic nephrectomy is a viable alternative to open nephrectomy in children. Further experience with this technique is required to establish its efficacy and reduce the operating time
York
G B
GB
Department of General Surgery, 59 MDW/MMKG, 2200 Bergquist Drive, Ste. 1, Wilford Hall Medical Center, Lackland AFB, TX 78236, USA.
Robertson
F M
FM
Cofer
B R
BR
Bomalaski
M D
MD
Lynch
S C
SC
D000293:Adolescent; D016063:Blood Loss, Surgical; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000601:surgery; D007223:Infant; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009392:Nephrectomy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000601:surgery