Follow-up imaging after laparoscopic heminephrectomy in children.
BACKGROUND
The radiological findings after laparoscopic heminephrectomy in children are not widely reported.


OBJECTIVE
To document the range of imaging appearances following laparoscopic heminephrectomy in children.


METHODS
We reviewed all imaging and all radiology reports performed on children in our institution who had undergone laparoscopic heminephrectomy over a 6-year period.


RESULTS
Between 2001 and 2007, 35 patients (24 girls, 11 boys) had laparoscopic heminephrectomy. The mean age at surgery was 3.5 years. The sites of surgery comprised 12 right upper, 5 right lower, 18 left upper and 3 left lower heminephrectomies. These numbers included three patients who had bilateral procedures. The most consistent postoperative finding was an avascular cyst related to the site of surgery, seen after 23 of 38 procedures. Of these 23 cysts, 13 were simple and 10 were septated and/or contained echogenic debris.


CONCLUSIONS
A cyst related to the site of laparoscopic heminephrectomy is a frequent postoperative occurrence but is not widely recognized for being simply this. Simple, anechoic, and septated appearances are possible. This cyst may be confusing to the radiologist and the clinician if they are not aware of the history of laparoscopic heminephrectomy and the technique that has been used. Whilst the exact aetiology of this cystic lesion is uncertain, all the patients in our series had a heminephrectomy performed with the use of an Endoloop (Ethicon, Somerville, NJ). No patients have required intervention to date.
Department of Radiology, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK. hiornm@gosh.nhs.uk
Melanie P
MP
Hiorns
Waseem
W
Mazrani
Imran
I
Mushtaq
Kieran
K
McHugh
D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007674:Kidney Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009392:Nephrectomy / Q000379:methods*; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D014463:Ultrasonography