Laparoscopic transperitoneal partial nephrectomy in children under 2 years old: a single-centre experience

Area of Science:

• Pediatric Urology
• Minimally Invasive Surgery
• Laparoscopic Surgery

Background:

• Duplicated pyeloureteral systems are common congenital anomalies in children.
• Surgical management is often necessary to preserve renal function and prevent complications.
• Laparoscopic approaches are increasingly favored for pediatric urological procedures.

Purpose of the Study:

• To evaluate the safety and efficacy of laparoscopic transperitoneal (TP) heminephrectomy.
• To assess outcomes in children under 2 years old with duplicated pyeloureteral systems.
• To compare the TP approach with other surgical techniques for this condition.

Main Methods:

• Retrospective review of 10 laparoscopic partial ureteronephrectomies (TP approach).
• Patients were children under 2 years old with duplicated pyeloureteral systems.
• Data included intraoperative details, postoperative outcomes, and follow-up via clinical exams and ultrasounds.

Main Results:

• Average operative time was 123 minutes with no conversions or intraoperative complications.
• Mean postoperative hospital stay was 2.9 days.
• One case of perirenal collection resolved spontaneously; one child had transient renal function diminution but remained asymptomatic.

Conclusions:

• The transperitoneal approach is recommended for laparoscopic heminephrectomy in young children.
• This technique provides superior vascular exposure and a larger working space, crucial for toddlers.
• It minimizes renal mobilization, potentially reducing morbidity associated with limited retroperitoneal space.