Retroperitoneal laparoscopic vs open partial nephroureterectomy in children

Area of Science:

• Pediatric surgery
• Minimally invasive surgery
• Urologic oncology

Background:

• Partial nephroureterectomy is a surgical procedure to remove a portion of the kidney and ureter.
• Open surgery has been the traditional approach for this procedure in children.
• Minimally invasive techniques are increasingly being explored to improve patient outcomes.

Purpose of the Study:

• To compare the outcomes of retroperitoneal laparoscopic partial nephroureterectomy with conventional open partial nephroureterectomy in pediatric patients.
• To evaluate the safety, feasibility, and efficacy of the laparoscopic approach.

Main Methods:

• A retroperitoneal laparoscopic partial nephroureterectomy was performed on 15 children using a three-trocar approach.
• Polar vessels were identified and clipped/coagulated; parenchyma was transected with a harmonic scalpel.
• A comparison group of 13 children underwent open partial nephroureterectomy.

Main Results:

• Operative duration was similar between laparoscopic (152 min) and open (146 min) groups.
• Blood loss was minimal in both groups (< 20 mL).
• Hospital stay was significantly shorter for the laparoscopic group (1.4 days) compared to the open group (3.9 days) (P < 0.001).

Conclusions:

• Retroperitoneal laparoscopic partial nephrectomy is a safe and feasible surgical option for children.
• The laparoscopic approach offers a significant advantage by reducing hospital stay.
• Further research may explore long-term outcomes and expanded indications.