LAPAROSCOPIC HEMINEPHROURETERECTOMY IN PEDIATRIC-PATIENTS

Purpose: An increasing slumber of operative procedures in pediatric ur ology can be performed by laparoscopy. We report our experience with l aparoscopic heminephroureterectomy, which is a typical operation in pe diatric patients, Materials and Methods: Laparoscopic heminephroureter ectomy was performed in 14 consecutive children. In 12 cases 7 upper r enal poles were removed for ectopic refluxing megaureter and obstructi ve ureterocele in 5 and 2, respectively, In 5 children lower poles wer e destroyed by reflux nephropathy, In 2 children laparoscopic upper po le heminephroureterectomy for obstructive ureterocele was combined wit h a Pfannenstiel incision for reimplantation of the refluxing lower po le ureter, Results: All operations were completed as planned, Operativ e time was 180 to 330 minutes (mean 222) in group 1 and 345 to 510 (me an 427) in group 2, Blood loss was minimal (10 to 30 mi,) and there we re no intraoperative or postoperative complications. Mean postoperativ e hospital stay in groups 1 and 2 was 4.4 and 7.5 days, respectively. Conclusions: Laparoscopic heminephroureterectomy in children is feasib le and associated with minimal blood loss, low morbidity and a low com plication rate. The disadvantage is the long operative time, This tech nically demanding procedure should be performed only at specialized ce nters.