Bilateral laparoscopic nephrectomy with simultaneous peritoneal dialysis catheter implantation.
Bilateral nephrectomy prior to transplantation is indicated in some patients with end-stage renal disease. The indications for bilateral nephrectomy include persistent heavy proteinuria, refractory hypertension, and urinary tract infections. We report an eight-month-old baby with male pseudohermaphroditism and renal failure secondary to diffuse mesangial sclerosis. While awaiting renal transplantation, dialysis became necessary and the child presented standard drug therapy-resistant hypertension. A bilateral nephrectomy was performed simultaneously to peritoneal dialysis catheter implantation by using laparoscopy. At the present time, the patient is doing well with ambulatory dialysis and all antihypertensive medication has been discontinued. We recommend this technique in children who require bilateral nephrectomy and peritoneal dialyisis. Not only is it somewhat less aggressive than traditional open surgery, but it also reduces post-operative pain, allows earlier initiation of peritoneal dialysis, and improves cosmetic appearance.
Martínez Urrutia
M J
MJ
Department of Paediatric Urology, La Paz University Hospital, Madrid, Spain. mjmu@hotmail.com
Olivares Arnal
P
P
López Pereira
P
P
Lobato Romera
R
R
Alonso Melgar
A
A
Jaureguizar Monereo
E
E
D002408:Catheters, Indwelling; D015897:Comorbidity; D012734:Disorders of Sex Development / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D050527:Mesangial Cells / Q000473:pathology; D009392:Nephrectomy / Q000379:methods*; D009852:Omentum / Q000601:surgery; D010149:Postoperative Pain / Q000517:prevention & control; D010530:Peritoneal Dialysis; D012598:Sclerosis