Transumbilical laparoscopic versus conventional partial nephrectomy in children with kidney duplication anomalies

Abstract

Objective To compare the differences among transumbilical single incision laparoscopy versus open surgery or conventional laparoscopy for partial nephrectomy of kidney and ureter duplication. Methods Retrospective analyses and follow-ups were performed for 88 kidneys of 87 children undergoing partial nephrectomy from October 2007 to September 2013. Operative duration, blood transfusion, postoperative drainage, postoperative hospital stay, short and long-term complications were recorded. Results They were divided into transumbilical single incision laparoscopy(n=37), conventional laparoscopy(n=14) and open surgery(n=37) groups. Age, weight and proportion of left or right side involvement showed no significant difference between groups. The mean operative duration of transumbilical single incision laparoscopy group was(184.9±56.9)min. And it had no difference with traditional laparoscopy group(170.4±35.6) min, but longer than open surgery group(124.7±38.9) min. The transfusion rate of transumbilical single incision laparoscopic group(9/37, 24.3%) was higher than that of open surgery group(3/37, 8.1%), but had no difference with conventional laparoscopy group(2/14, 14.2%). No difference existed between groups in drainage amount, drainage time, days of postoperative fever or postoperative hospital stay. During early postoperative period, surgical area effusion or cyst in transumbilical single incision laparoscopic group(n=4), traditional laparoscopy group(n=1) and open surgery group(n=4) disappeared completely. No other complications occurred during long-term follow-ups. Conclusions With longer operative duration and higher blood transfusion rate, transumbilical single incision laparoscopy for partial nephrectomy of duplicated kidney is both safe, effective and aesthetic. Key words: Urogenital abnormalities; Ureter; Nephrectomy; Laparoscopy