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Retroperitoneoscopic approach for partial nephrectomy in children with duplex kidney: A case report
Di-Xiang Chen1, Zi-Hao Wang2, Shan-Jie Wang3
1Department of Pediatrics, PLA General Hospital, Beijing 100853, China.
World Journal of Clinical Cases
|June 12, 2019
Summary
Retroperitoneal laparoscopic surgery is a viable option for pediatric patients with duplex kidneys experiencing hydronephrosis. This minimally invasive approach offers effective treatment for complex renal malformations.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Congenital Renal Anomalies
Background:
- Renal duplication anomalies affect approximately 1 in 125 children.
- Symptomatic presentations include hydronephrosis, vesicoureteral reflux, and incontinence, often necessitating surgical intervention.
- Laparoscopy and retroperitoneoscopy are primary surgical approaches for partial nephrectomy in these cases.
Observation:
- A 9-year-old patient presented with left kidney hydronephrosis due to a renal duplication malformation.
- Imaging revealed significant pelvic and ureteral dilation in the upper moiety, with a smaller, atrophic upper pole and a dilated lower pole.
- The patient underwent retroperitoneal laparoscopic nephrectomy and ureterectomy.
Findings:
- The retroperitoneal laparoscopic procedure was performed without complications, with minimal blood loss (100 mL).
- Pathological examination confirmed renal parenchyma atrophy, hydronephrosis, and ureteral cystic dilation.
- The patient was discharged on postoperative day 6, with the drainage tube removed on day 3.
Implications:
- Retroperitoneoscopic partial nephrectomy demonstrates feasibility and effectiveness in select pediatric cases of duplex kidney.
- Minimally invasive techniques offer a promising alternative for managing complex congenital urinary tract malformations in children.
- This approach may lead to improved patient outcomes and reduced recovery times.
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