Laparoscopic retroperitoneal renal and adrenal surgery in children.
OBJECTIVE
To retrospectively assess the use of a retroperitoneal laparoscopic approach for simple nephrectomy and adrenalectomy in children.


METHODS
All retroperitoneal laparoscopic renal and adrenal procedures carried out in children and completed between 1993 and March 2000 were reviewed retrospectively. Analgesic requirements, hospital stay, complications and blood loss were reviewed. The technique is described in detail.


RESULTS
Forty-eight retroperitoneal laparoscopic procedures were completed in 48 patients (mean age 5.5 years, range 0.5-16). The procedures included nephrectomy (22), nephroureterectomy (15), renal biopsy (six), cyst ablation (two) and simple adrenalectomy (three). In all, 11 procedures were undertaken in children aged < 2 years. Forty-one (91%) of the children undergoing renal procedures were discharged in < 24 h. Two patients underwent three adrenalectomies. Two children required conversion to open surgery, one undergoing a right-sided adrenalectomy and one a nephrectomy. The mean operative duration for nephrectomy and nephroureterectomy was 75 min, and for adrenalectomy was 115 min.


CONCLUSIONS
Renal and adrenal surgery in children is a safe and rapid procedure with retroperitoneal laparoscopy. The operative duration for nephrectomy and nephroureterectomy are frequently < 1 h. In addition, laparoscopic surgery offers significant advantages in terms of cosmesis and a quicker recovery.
Shanberg
A M
AM
Antoci Center for Paediatric Urology and Nephrology, University of California at Irvine Medical Center, Orange, CA, USA. amshanbe@uci.edu
Sanderson
K
K
Rajpoot
D
D
Duel
B
B
D000293:Adolescent; D000307:Adrenal Gland Diseases / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D016063:Blood Loss, Surgical; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007674:Kidney Diseases / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D009392:Nephrectomy / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome