[Our experience in retroperitoneoscopic total or partial nephrectomies].
M S Fernández Córdoba1, J Gonzálvez Piñera, Y Argumosa Salazar
1Servicio de Cirugía Pediátrica, Complejo Hospitalario Universitario de Albacete. msfernandezc@sescam.jccm.es
Summary
Retroperitoneal laparoscopy is a safe alternative for benign kidney conditions, offering faster recovery than open surgery. The posterior approach may reduce operative time for total nephrectomies.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Pediatric Surgery
Background:
- Retroperitoneal laparoscopic surgery is increasingly used for benign renal conditions.
- It offers an alternative to open and transperitoneal approaches.
Purpose of the Study:
- To evaluate the safety and efficacy of the retroperitoneal laparoscopic approach for pediatric renal surgery.
- To compare outcomes between lateral and posterior prone positions.
Main Methods:
- Retrospective review of 20 retroperitoneal laparoscopic procedures (13 total nephrectomies, 7 heminephrectomies) in children.
- Procedures performed using either lateral or posterior prone positioning.
- Data collected on operative time, oral feeding resumption, hospital stay, and complications.
Main Results:
- Mean operative time was 200 minutes for partial and 278 minutes for total nephrectomies.
- Oral feeding resumed at 11.4 hours, with an average hospital stay of 1.58 days for total nephrectomies and 2.18 days for heminephrectomies.
- The posterior approach showed a shorter operative time for total nephrectomies (170 min vs. 216 min, P=0.024) with no significant differences in other outcomes.
- No intraoperative bleeding occurred; complications included urine leaks, infections, and transient hematuria.
Conclusions:
- Retroperitoneoscopy provides safe renal access, avoiding transperitoneal morbidity.
- The posterior approach may offer advantages in operative time and workspace maximization.
- This approach is a viable and safe option for pediatric renal surgery.
