title: Retroperitoneoscopic renal surgery in children: our experience.
abstract: BACKGROUND
  Laparoscopic renal surgery has become an accepted approach for benign disease in adult and pediatric urology. We present our experience in renal laparoscopy in infants during the past 5 years and evaluate our series to establish the safety and efficacy of such procedures in children.
  
  
  METHODS
  From August 1999 to December 2004, we performed 32 renal laparoscopic procedures on 31 children aged 12 months to 16 years (mean, 42 months). Twenty-seven patients underwent unilateral retroperitoneal nephrectomy; 1 child with Denis Drash syndrome underwent transperitoneal bilateral nephrectomy; 2 children underwent renal cyst unroofing; and 1 child with lymphoma underwent retroperitoneal laparoscopic renal biopsy. Indications for surgery were: renal function <9% in cases of unilateral nephrectomy; the prevention of renal neoplastic changes in the patient with Denys-Drash syndrome; symptomatic large renal cysts; and suspected lymphoma not diagnosed with a previous percutaneous biopsy.
  
  
  RESULTS
  All procedures were completed laparoscopically. In 6 cases, the accidental opening of the peritoneum did not require conversion to open surgery. Intraoperative blood loss was minimal. One patient who underwent a retroperitoneal nephrectomy required a blood transfusion for postoperative bleeding into the retroperitoneal space. Twenty-four of 27 unilateral retroperitoneal nephrectomy patients were discharged on postoperative day 2. Mean follow-up was 30 months (range, 6-64 months). Cosmetic results were excellent in all patients and no long-term complications have been encountered so far.
  
  
  CONCLUSIONS
  Laparoscopic urologic surgery may be performed in children with minimal morbidity, minimal postoperative discomfort, improved cosmetic results, and a short hospital stay.
authors.affiliation: Division of Pediatric Urology, OIRM Santa Anna, Torino, Italy. batadini@tin.it
authors.forename: Barbara
authors.initials: B
authors.lastname: Tadini
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Repetto
authors.forename: Nino
authors.initials: N
authors.lastname: Guarino
authors.forename: Roberto
authors.initials: R
authors.lastname: Lace
authors.forename: Efisia
authors.initials: E
authors.lastname: Marras
authors.forename: Marco
authors.initials: M
authors.lastname: Bianchi
mesh_terms: D000293:Adolescent; D001706:Biopsy / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; 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; D016896:Treatment Outcome