Laparoscopic Upper-pole Heminephrectomy for the Management of Duplex Kidney: Outcomes of a Multicenter Cohort.

Autor: Szklarz MT; Department of Pediatric Urology, Hospital 'Prof. Dr. Juan P. Garrahan', Buenos Aires, Argentina. Electronic address: tatiana.szklarz@gmail.com., Ruiz J; Department of Pediatric Urology, Hospital 'Prof. Dr. Juan P. Garrahan', Buenos Aires, Argentina., Moldes JM; Department of Pediatric Surgery and Urology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Sentagne A; Department of Pediatric Surgery and Urology, Hospital de Niños de la Santísima Trinidad, Córdoba, Argentina., Tuchbaum V; Department of Pediatric Surgery and Urology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Tessi C; Department of Pediatric Urology, Hospital 'Prof. Dr. Juan P. Garrahan', Buenos Aires, Argentina., Imizcoz FL; Department of Pediatric Urology, Hospital 'Prof. Dr. Juan P. Garrahan', Buenos Aires, Argentina., Weller S; Department of Pediatric Urology, Hospital 'Prof. Dr. Juan P. Garrahan', Buenos Aires, Argentina., Vagni R; Department of Pediatric Surgery and Urology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Ormaechea MN; Department of Pediatric Surgery and Urology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Burek C; Department of Pediatric Urology, Hospital 'Prof. Dr. Juan P. Garrahan', Buenos Aires, Argentina., Sager C; Department of Pediatric Surgery and Urology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., De Badiola F; Department of Pediatric Surgery and Urology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Corbetta JP; Department of Pediatric Urology, Hospital 'Prof. Dr. Juan P. Garrahan', Buenos Aires, Argentina.
Jazyk: angličtina
Zdroj: Urology [Urology] 2021 Oct; Vol. 156, pp. 245-250. Date of Electronic Publication: 2021 Jan 23.
DOI: 10.1016/j.urology.2021.01.032
Abstrakt: Objective: To analyze the outcomes of patients undergoing upper-pole heminephrectomy surgery and to assess the different variables that may have an impact on outcome, specifically regarding morbidity and the need for further surgeries.
Materials and Methods: A retrospective study of patients who underwent laparoscopic upper-pole heminephrectomy for a nonfunctional moiety between August 2007 and December 2019 was conducted at 3 centers. A total of 130 patients met the inclusion criteria. A transperitoneal approach was used. The following variables were evaluated: (1) preoperative: presentation, presence of ureterocele and history of ureterocele incision, hydronephrosis grade, presence of vesicoureteral reflux (VUR), and differential renal function (DRF) on renal scintigraphy; and (2) postoperative outcomes: Doppler ultrasound, renal scintigraphy, complications, febrile urinary tract infection, lower urinary tract symptoms, and need for further surgery. Findings were considered statistically significant at P <.05.
Results: Postoperative complications were observed in 5 patients (3.8%). Six patients (4.6%) needed further surgeries after heminephrectomy. The presence of ureterocele and VUR was related with the need for further surgeries odds ratio (OR) 4.91, P = .0415) and the occurrence of postoperative febrile urinary tract infection (OR 2.81, P = .0376). A 13.9% incidence of lower urinary tract symptoms was found with no difference between patients with ureterocele and those with an ectopic ureter. Renal scintigraphy showed a median decrease in DRF of 2.7%. No patient had complete loss of function.
Conclusion: Laparoscopic upper-pole heminephrectomy showed to be a feasible and safe procedure. In most patients this surgery will be the definitive procedure. Patients with both VUR and ureterocele will need special consideration. No significant loss of function in the remaining lower moiety was found.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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