Transperitoneal Laparoscopic Upper Pole Heminephrectomy in Pediatric Patients with Duplex Kidneys: Comparison with an Age-Matched Cohort of Open Surgery
유달산, 심명선, 김성철, 하성헌, 권택민, 김건석,
소속 상세정보
유달산 ( You Dal-San )
울산대학교 의과대학 서울아산병원 비뇨기과학교실
심명선 ( Shim Myung-Sun )
울산대학교 의과대학 서울아산병원 비뇨기과학교실
김성철 ( Kim Seong-Cheol )
울산대학교 의과대학 서울아산병원 비뇨기과학교실
하성헌 ( Ha Seong-Heon )
울산대학교 의과대학 서울아산병원 비뇨기과학교실
권택민 ( Kwon Taek-Min )
울산대학교 의과대학 서울아산병원 비뇨기과학교실
김건석 ( Kim Kun-Suk )
울산대학교 의과대학 서울아산병원 비뇨기과학교실
KMID : 0358320090500090879
Abstract
Purpose: We evaluated the safety and feasibility of transperitoneal laparoscopic upper pole heminephrectomy (TLUHN) in pediatric patients by comparing an age-matched cohort undergoing open upper pole heminephrectomy (OUHN) by a single surgeon.
Materials and Methods: A total of 10 OUHNs were performed between 1995 and 2003 and 10 TLUHNs between 2003 and 2008. The 10 patients in each group were matched by age (p=0.94), gender (p=1.0), and body weight (p=0.91).
Results: There was no open conversion in the TLUHN group. The median operative time in the TLUHN and OUHN groups was 174 minutes (range, 98-205) and 190 minutes (range, 120-258), respectively (p=0.19). In the TLUHN and OUHN groups, the median blood loss was 25 ml (range, 20-30) and 35 ml (range, 20-100) (p=0.74), the median analgesic requirement was 0 hours (range, 0-42) and 0 hours (range, 0-87) (p=0.16), and the median hospital stay was 5.5 days (range, 3-7) and 7 days (range, 3-19) (p=0.01), respectively. There were no intraoperative complications in either group. Postoperative atelectasis occurred in two and five patients in the TLUHN and OUHN groups, respectively. Similar results were found in the subanalysis of patients younger than 24 months.
Conclusions: TLUHN is safe and feasible even in small children and infants. Furthermore, decreased hospital stay is the main advantage of the laparoscopic approach compared with open surgery.
키워드
Laparoscopy;Nephrectomy;Pediatrics
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