Comparison of retroperitoneal laparoscopic and open nephrectomy for benign renal diseases in children.
OBJECTIVE
To compare the results of retroperitoneal laparoscopic versus open nephrectomy for benign renal diseases in children.


METHODS
From January 1999 to February 2003, retroperitoneal nephrectomy or nephroureterectomy was performed in 23 consecutive children (7 girls and 16 boys). The median patient age was 4 years (range 1 to 13). The disease was on the right side in 9 children and on the left side in 14. Operative and convalescence parameters, including operative time, blood loss, transfusion rate, resumption of oral intake, hospital stay, and complication rate, were evaluated in both groups.


RESULTS
All laparoscopic cases were completed successfully without conversion to open surgery. The median operative time and estimated blood loss were not statistically different between the two groups. No major perioperative complications occurred in any child, but a wound site complication occurred in 1 child who had undergone open surgery. The median hospital stay of the open group was 4 days (range 3 to 14), significantly longer than that of the laparoscopic group (median 2.5 days, range 2 to 6; P = 0.018). The cosmetic results of the laparoscopic group were excellent; the scars from the trocar sites were barely discernible at the initial postoperative visit. Convalescence was uneventful in all patients.


CONCLUSIONS
Retroperitoneal laparoscopic nephrectomy and nephroureterectomy may be performed for benign disease in children with minimal morbidity, improved cosmetic results, and a short hospital stay. Our findings indicate that retroperitoneal laparoscopic nephrectomy is appropriate in children and superior, in some instances, to open surgery.
Ku
Ja Hyeon
JH
Department of Urology, Seoul National University College of Medicine, Seoul, South Korea.
Yeo
Woon Geol
WG
Choi
Hwang
H
Kim
Hyeon Hoe
HH
D000293:Adolescent; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007674:Kidney Diseases / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009392:Nephrectomy / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery