Laparoendoscopic Single-Site Urologic Surgery in Children Less Than 5 Years of Age
Ganpule Arvind, Sheladiya Chetan, Mishra Shashikant, Sabnis Ravindra, Desai Mahesh,
소속 상세정보
( Ganpule Arvind )
India Muljibhai Patel Urological Hospital Department of Urology
( Sheladiya Chetan )
India Muljibhai Patel Urological Hospital Department of Urology
( Mishra Shashikant )
India Muljibhai Patel Urological Hospital Department of Urology
( Sabnis Ravindra )
India Muljibhai Patel Urological Hospital Department of Urology
( Desai Mahesh )
India Muljibhai Patel Urological Hospital Department of Urology
KMID : 0358320130540080541
Abstract
Purpose: We report our experience with laparoendoscopic single-site (LESS) urological procedures in children less than 5 years of age. Materials and Methods: Ten patients (11 procedures) underwent LESS through the umbilicus. Seven patients underwent nephrectomy and three patients underwent pyeloplasty (one simultaneous bilateral). R-port port (Advanced Surgical Concepts, Ireland) was used in nine cases, in one case, the Gelpoint access port (Applied Medical, Rancho Santa Margarita, CA, USA) was used. The Olympus Endoeye camera with coaxial light cable was used. The hilum was secured in all cases with Hem-o-Lok clips (Teleflex Medical, Research Triangle Park, NC, USA) except in one case in which an Endo GIA stapler (Covidien Surgical, Norwalk, CT, USA) was used. Results: All procedures were technically successful. Accessory port (3 mm) was used in 3 patients. Mean age in nephrectomized patients was 3.14±1.7 years, the mean operative room time (ORT) was 97.5±12.54 minutes. In the pyeloplasty group, mean ORT was 192±47.16 minutes and mean age was 2.43±2.3 years. Bilateral pyeloplasty was done in a 4-month-old infant. The ORT in this case was 180 minutes. A follow-up renogram done in the pyeloplasty patients (n=2) showed good drainage. Mean length of stay was 3.6 days (range, 3 to 6 days).The analgesic requirement was 23.86 mg (range, 12.5 to 50 mg) of diclofenac sodium. Conclusions: LESS is technically feasible in patients as young as 4 months of age. It has the potential to offer better cosmesis. This needs to be proved in further comparative studies. Development of miniature instruments will further the growth of LESS in this age group.
키워드
Laproscopy; Nephrectomy; Pyeloplasty
원문 및 링크아웃 정보
등재저널 정보