Heminephrectomy in the pediatric population – single-center comparison of the open versus transperitoneal laparoscopic approach

Abstract

IntroductionHeminephrectomy is considered the method of choice in the treatment of symptomatic or poorly working moiety of a duplex kidney as well as in oncology.AimThe study aims to retrospectively analyze the laparoscopic approach to heminephrectomy (LHN) in comparison with the open approach (OHN).Material and methodsFrom 2011 to 2020, 28 heminephrectomies were performed in the Clinical Ward of Pediatric Surgery and Urology of the Regional Specialized Children’s Hospital in Olsztyn: 10 with the laparoscopic transperitoneal method (LHN), and 18 with the open method (OHN). The mean age was 37.4 months (1–197 months). In total, 20 patients were female, and 8 were male. Loss of function of the moiety was a prerequisite for surgery. Hydronephrosis, dysplasia of the moiety, and vesicoureteral reflux were the most prevalent in both groups. Data regarding patients were collected based on available medical documentation and retrospectively analyzed.Results and discussionThere was no significant difference between the LHN and OHN groups regarding mean operating time (157 vs 128 minutes; <i>P</i> = 0.226) and mean postoperative hospital stay (5.20 vs 6.53; <i>P</i> = 0.64). The refeeding time is comparable and not statistically significant (1.90 vs 1.83 days; <i>P</i> = 0.555). Postoperative analgesic intake was found to be significantly lower (10.4 vs 17.5 doses, <i>P</i> = 0.004).ConclusionsBoth open and laparoscopic approaches are safe and feasible in the pediatric population. Both are comparable in operative time, hospital stay and refeeding time. LHN displays a better cosmetic effect and requires significantly lesser analgesic use.