2009, Number 5
Rev Mex Urol 2009; 69 (5)
Camarena-Reynoso HR, Cantellano-Orozco M, Vázquez-Ortega L, Shuck-Bello C, Leos-Acosta C, Aguilar-Anzúrez R, Olivera-Vázquez J, Cuevas-Alpuche JO
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ABSTRACTIntroduction: The patient is a male child, 18 months of age. Disease onset began at 1 month of age with vomiting, fever of 39°C, irritability upon urinating, frequent urination and pyuria. Recurrent urinary tract infection was diagnosed and patient was referred to the Instituto Nacional de Pediatría at 1 year of age. Kidney and bladder ultrasound revealed left hydronephrosis. Urologic multislice computed tomography (MSCT) showed a left double collector system with pelvic and superior caliceal system hydronephrosis. The left superior pole of the kidney was poorly enhanced and there was probable left ureterocele. Double ureteral meatus and left ureterocele were confirmed by cystoscopy. Renal scintiscan with mercapto acetyl tri glycine (MAG 3) revealed left superior pole dysfunction. Posterior retroperitoneal laparoscopic partial nephrectomy was performed.
Discussion: Laparoscopic partial nephrectomy is currently performed only in specialized centers and the number of pediatric procedures is limited. Conversion rate during the learning curve of this procedure is high and technical difficulties continue to be a challenge, especially in infants and toddlers with dilated collector systems.
Conclusions: Laparoscopic partial nephrectomy with a posterior retroperitoneal approach in children is a useful procedure with low morbidity and shorter hospital stay. It can be used in both benign and malignant pathologies with good results.