Nefrectomía laparoscópica por vía transperitoneal en la población pediátrica

Purpose: To Evaluate the safety and efficacy of laparoscopic Transperitoneal nephrectomy in a series of pediatric patients. Materials and Methods: We describe the patients who underwent laparoscopic Transperitoneal nephrectomy, between July 2008 and April 2009 in three hospitals in Bogotá, Colombia. We have analyzed demographic variables, surgical indications, surgery outcomes and preoperative and postoperative complications. Results: During the study period we performed a total of 11 nephrectomies (3 boys and 8 girls). Seven nephrectomies and four a nephroureterectomies were performed. In 8 of those cases the left renal unit was removed. The reason for the surgeries were: Hydronephrosis due to stenosis of the pyelo ureteral junction (5 cases), reflux nephropathy (3 cases), obstructive megaureter (2 cases) and multicystic renal dysplasia (1 case). The average age of the patients was 65 months (10-144 months) and their weight 18 Kg. (7-34 kg). The Average duration or length of the procedure was 132 minutes (70-200 minutes). No case required conversion to open surgery, nor were there any intraoperative complications. One patient required a postoperatively transfusion. Conclusions: The Transperitoneal laparoscopic nephrectomy in children is safe and effective, given the known benefits of laparoscopic approaches in the upper urinary tract. In our field and/or specialty it is imperative to execute a great number of such procedures. This should be the standard of treatment for renal ablative procedures in the pediatric population. Objetivo: Evaluar la seguridad y eficacia de la nefrectomía laparoscópica por vía trans peritoneal en una serie de pacientes pediátricos. Materiales y Métodos: Se describen todos los pacientes llevados a nefrectomía laparoscópica trans peritoneal entre Julio de 2008 y Abril de 2009 en tres hospitales de Bogotá. Se analizaron variables demográficas, indicaciones quirúrgicas, resultados quirúrgicos y complicaciones peri y postoperatorias. Resultados: Durante el período de tiempo estudiado se realizaron un total de 11 nefrectomías (3 niños y 8 niñas). En 7 casos se realizó nefrectomía y en 4 casos nefro-ureterectomía. En 8 de los casos la unida renal extirpada fue izquierda. Las patologías de base que condicionaron el procedimiento quirúrgico fueron: Hidronefrosis por estenosis de la unión pielo ureteral (5 casos), Nefropatía del reflujo (3 casos), megauréter obstructivo (2 casos) y displasia renal multiquística (1 caso). El promedio de e