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首页> 外文期刊>Surgical Endoscopy >Retroperitoneoscopic partial nephrectomy in children: a multicentric international comparative study between lateral versus prone approach
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Retroperitoneoscopic partial nephrectomy in children: a multicentric international comparative study between lateral versus prone approach

机译：儿童的腹膜静脉椎间盘突出部分肾切除术：横向与易发法的多中心国际比较研究

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BackgroundVery limited informations are currently available about the best approach to perform retroperitoneoscopic surgery. This multicentric international study aimed to compare the outcome of lateral versus prone approach for retroperitoneoscopic partial nephrectomy (RPN) in children.MethodsThe records of 164 patients underwent RPN in 7 international centers of pediatric surgery over the last 5years were retrospectively reviewed. Sixty-one patients (42 girls and 19 boys, average age 3.8years) were operated using lateral approach (G1), whereas 103 patients (66 girls and 37 boys, average age 3.0years) underwent prone RPN (G2). The two groups were compared in regard to operative time, postoperative outcome, postoperative complications, and re-operations.ResultsThe average operative time was significantly shorter in G2 (99min) compared to G1 (160min) (p=0.001). Only 2 lateral RPN required conversion to open surgery. There was no significant difference between the two groups as for intraoperative complications (G1:2/61, 3.3%; G2:6/103, 5.8%; p=0.48), postoperative complications (G1:9/61, 14.7%; G2:17/103, 16.5%; p=0.80), and re-operations (G1:2/61, 3.3%; G2:4/103, 3.8%; p=0.85). Regarding postoperative complications, the incidence of symptomatic residual distal ureteric stumps (RDUS) was significantly higher in G2 (7/103, 6.8%) compared to G1 (1/61, 1.6%) (p=0.001). Most re-operations (4/6, 66.6%) were performed to remove a RDUS .ConclusionsBoth lateral and prone approach are feasible and reasonably safe to perform RPN in children but the superiority of one approach over another is not still confirmed. Although prone technique resulted faster compared to lateral approach, the choice of the technique remains dependent on the surgeon's personal preference and experience. Our results would suggest that the lateral approach should be preferred to the prone technique when a longer ureterectomy is required, for example in cases of vesico-ureteral reflux into the affected kidney moiety, in order to avoid to leave a long ureteric stump that could become symptomatic and require a re-intervention.
机译：背景信息目前有限的信息目前可以获得最佳方法来进行逆床的术语手术。这种多中心国际研究旨在比较儿童腹膜静脉间隙部分肾切除术（RPN）的横向与易受态度的结果。回顾性审查了164名患者164名患者的164名患者的记录。回顾性地审查了过去5年的7次国际儿科手术中心的RPN。使用横向方法（G1）运营六十一名患者（42名女孩和19名男孩，平均年龄3.8岁），而103名患者（66名女孩和37名男孩，平均年龄3.0年龄）接受了Prone RPN（G2）。在操作时间，术后结果，术后并发症和重新运行方面进行了比较这两组。与G1（160min）相比，G2（99min）的平均手术时间明显短，（P = 0.001）。只有2个横向RPN需要转换为开放手术。两组与术中并发症之间没有显着差异（G1：2 / 61,3.3％; G2：6 / 103,5.8％; p = 0.48），术后并发症（G1：9 / 61,14.7％; G2 ：17 / 103,16.5％; p = 0.80），重新运行（G1：2 / 61,3.3％; G2：4 / 103,3.8％; P = 0.85）。关于术后并发症，与G1（1/61,1.6％）相比，G2（7/103,6.8％）的症状残留远端输尿管残肢（RDU）的发病率明显高于G2（7/103,6.8％）（P = 0.001）。大多数重新运营（4/6,66.6％）进行了去除RDU .Clclusionsboth横向和易于方法是在儿童中进行RPN的可行性和合理的方法，但是一种方法的优势仍未得到证实。尽管与横向方法相比，易于技术导致更快，但该技术的选择仍然依赖外科医生的个人喜好和经验。我们的研究结果表明，当需要更长的输尿管切除术时，横向方法应该优选易于技术，例如在受影响的肾脏部分进入受影响的肾脏部分的情况下，以避免留下可能成为的长输尿管肿块症状性并需要重新干预。

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