Retroperitoneal laparoscopic nephrectomy in children younger than nine years-old: state of the art.

Abstract

In Portugal, there is very few experience in pediatric retroperitoneoscopy. The authors present the first Portuguese series of retroperitoneal laparoscopic nephrectomies (RLN) in children younger than nine years-old, as well as a literature review about the theme.Retrospective analysis of clinical charts of all children submitted to RLN between January 2009 and December 2009 in a Pediatric Surgery Department. The literature review was made searching related articles in Medline.Eight RLN were preformed. The medium age of the patients was 4,5 years-old (minimum = 11 months, maximum = 8,6 years). The indications for surgery were: four multicystic kidneys, three reflux nephropathy, and one obstructive nephropathy. Four RLN were preformed on the left side. The medium operative time was 99 minutes (minimum = 50 minutes, maximum = 180 minutes). There was a shortening of operative time as the surgical team got more experienced. There were no conversions to open surgery. Medium hospital stay was 1,5 days (minimum = 1 day, maximum = 2 days). There were no intra-operative and no post-operative complications.RLN is feasible in children younger than nine years-old and should be considered standard treatment in pediatric population.