title: Comparison of laparoscopic and open partial nephrectomy for duplication anomalies in children.
abstract: OBJECTIVE
  We compared the outcome of laparoscopic vs open PN for duplication anomalies at our institution.
  
  
  METHODS
  We retrospectively reviewed the records of all patients undergoing PN within the last 4 years.
  
  
  RESULTS
  A total of 34 patients (16 females) were divided into 2 groups. Group 1 consisted of 20 patients undergoing open PN between 2000 and 2003, and group 2 consisted of 14 patients undergoing laparoscopic PN between 2003 and 2004. Mean patient age was 21 months in group 1 and 18 months in group 2. Diagnosis was ectopic ureter in 18 patients, ureterocele in 11, VUR in 4 and ureteropelvic junction obstruction in 1. Cystoscopy was performed as part of the procedure in 30% of the patients in group 1 and 100% of those in group 2. Simultaneous lower tract procedures were performed in 3 patients in group 1 and 2 patients in group 2. Mean duration of PN was 115 minutes for group 1 and 180 minutes for group 2. There was no significant bleeding or need for transfusion except in 1 patient in the open group. Median hospitalization was 3 days for group 1 and 2 days for group 2. Mean analgesic requirement was 2.3 doses of opioids and 2 doses of ketorolac for group 1, and 3.2 doses of opioids for group 2. Acetaminophen only was used in 3 of 20 patients in group 1 and 5 of 14 in group 2. There were 2 complications in each group, namely 1 case of ureteral bleeding and 1 lower pole ureteral injury in group 1, and 1 omental hernia and 1 urinoma in group 2.
  
  
  CONCLUSIONS
  Laparoscopic PN is feasible even in small infants, and the results are comparable to the open procedure. Length of hospitalization was shorter in the laparoscopic group. In our series the learning curve for this technique was rapid, and after a few cases the procedure could be done in the same time as open surgery, with the advantages offered by laparoscopy.
authors.affiliation: Division of Urology, A. I. duPont Hospital for Children, Wilmington, Delaware 19806, USA.
authors.forename: Lisandro
authors.initials: L
authors.lastname: Piaggio
authors.forename: Julie
authors.initials: J
authors.lastname: Franc-Guimond
authors.forename: T Ernesto
authors.initials: TE
authors.lastname: Figueroa
authors.forename: Julia S
authors.initials: JS
authors.lastname: Barthold
authors.forename: Ricardo
authors.initials: R
authors.lastname: González
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007668:Kidney / Q000002:abnormalities* / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D009392:Nephrectomy / Q000379:methods*; D012189:Retrospective Studies; D014513:Ureter / Q000002:abnormalities* / Q000601:surgery*