title: Benefits of transperitoneal approach to bilateral pretransplant laparoscopic nephrectomies in pediatric patients.
abstract: BACKGROUND
  Pediatric renal transplant patients may require native nephrectomy to avoid complications at the time of kidney transplantation. We have performed unilateral and bilateral transperitoneal pretransplant laparoscopic nephrectomies (PLNs), followed by living-related renal transplantation. The benefits of transperitoneal versus retroperitoneal dissection remain controversial.
  
  
  METHODS
  A retrospective review of patients who underwent unilateral or bilateral transperitoneal PLNs between May 1, 2001 and April 30, 2009 was performed. A transperitoneal approach was used in all patients.
  
  
  RESULTS
  Eight patients underwent transperitoneal PLN. Four patients were female, and the average age was 91 months (range, 9-199 months). Five of the cases involved bilateral nephrectomy. Average operating times, including hemodialysis catheter placement and other procedures, was 4.93 hours (range, 4.25-5.97 hours) for bilateral PLN and 3.93 hours (range, 2.57-5.48 hours) for unilateral PLN. The average hospital stay was 5.9 days. All patients underwent successful renal transplantation following PLN without rejection at an average 2.3 years of follow-up.
  
  
  CONCLUSIONS
  PLN appears to be an effective, safe method of removing potentially problematic, diseased kidneys prior to planned renal transplantation. A transperitoneal technique using four midline ports affords excellent access to both kidneys and, more importantly, allows for additional procedures to be completed simultaneously.
authors: Michigan State University College of Human Medicine, Grand Rapids, Michigan, USA. goslinbr@msu.edu
authors: Brent J
authors: BJ
authors: Goslin
authors: Timothy
authors: T
authors: Bunchman
authors: Daniel
authors: D
authors: Robertson
authors: James
authors: J
authors: DeCou
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D016030:Kidney Transplantation; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009392:Nephrectomy / Q000379:methods*; D010537:Peritoneum; D012189:Retrospective Studies