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Retroperitoneoscopic heminephroureterectomy for children with duplex anomaly: Initial experience
Akihiro Kawauchi1, Akira Fujito, Yasuyuki Naito
1Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan. kawauchi@koto.kpu-m.ac.jp
Summary
Retroperitoneoscopic heminephroureterectomy is a feasible and safe surgical option for children with duplex anomalies, offering good outcomes. Further optimization is needed to reduce operative time for this minimally invasive procedure.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Congenital Anomalies
Background:
- Duplex anomalies, particularly complete ureteral duplication with upper pole pathology, present surgical challenges in pediatric patients.
- Traditional open surgical approaches may lead to significant morbidity and cosmetic concerns.
Purpose of the Study:
- To assess the feasibility and safety of retroperitoneoscopic heminephroureterectomy in children diagnosed with duplex anomalies.
- To evaluate the postoperative outcomes and cosmetic results of this minimally invasive technique.
Main Methods:
- A retrospective review of five pediatric patients (four girls, one boy) with complete ureteral duplication undergoing retroperitoneoscopic heminephroureterectomy.
- Four patients had upper pole ectopic megaureters; one had an upper pole megaureter with ureterocele, managed with a combined approach.
Main Results:
- The mean operative time ranged from 346 to 420 minutes.
- Mean estimated blood loss was between 40-43 mL.
- No postoperative complications were observed, with all patients demonstrating normal renal function and pyelogram of the lower pole post-surgery.
Conclusions:
- Retroperitoneoscopic heminephroureterectomy is a feasible and safe surgical approach for pediatric duplex anomalies, yielding favorable cosmetic and functional results.
- Reducing the operative time remains an area for improvement in this technique.