Laparoscopic nephrectomy in children

Abstract

Introduction: Laparoscopic surgery has been of great benefit in children, especially laparoscopic nephrectomy. 

Objective: To report our experience in this technique in children. 

Material and methods: A review of all laparoscopic nephrectomies carried out in children between November 1992 and February 2001, a tranperitoneal procedure was used in all cases. 

Results: The procedure was carried out in 18 children, 13 girls and 5 boys with an average age of 7.9 years (range 8 months-15 years). Surgery was a total nephrectomy in 14, total nephroureterectomy in 3 and a heminephrectomy in 1. The average operative time was 91.9 minutes (range 25-180) and hospital stay 52.4 hours (range 20-72). The average intraoperative bleeding was 87.7ml (range 0-1 000). Only in 1 case open surgery was required due to incontrollable bleeding. There were no postoperative complications and no mortality. 

Conclusions: We conclude that laparoscopic nephrectomy should be considered as the first line surgical treatment in children requiring a nephrectomy for benign diseases. It has all the advantages of laproscopic surgery, comestical aspects, less postoperative pain and a faster revovery. All these factors have a large impact on the social and psychological aspects of a sick child and his family.