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Paediatric computer-assisted retroperitoneoscopic nephrectomy compared with open surgery.

Anderberg, Magnus LU ; Clementson Kockum, Christina LU and Arnbjörnsson, Einar LU (2011) In Pediatric Surgery International 27(7). p.761-767
Abstract
PURPOSE: Computer-assisted laparoscopic surgery (CALS) in children is increasingly used and has proven to be feasible and safe. However, its full potential remains unclear and clinical comparative studies hardly exist. The aim of this study was to prospectively evaluate our experience with CALS for performing retroperitoneal nephrectomies in children when compared with controls undergoing open surgery in terms of safety, operative time, blood loss, opoid requirements, the duration of hospital stay and complications. CHILDREN AND METHODS: Computer-assisted retroperitoneoscopic nephrectomy was undertaken in ten consecutive children, mean age at the time of surgery 6.4 (SD ± 4.5) years, and compared with a retrospectively collected control... (More)
PURPOSE: Computer-assisted laparoscopic surgery (CALS) in children is increasingly used and has proven to be feasible and safe. However, its full potential remains unclear and clinical comparative studies hardly exist. The aim of this study was to prospectively evaluate our experience with CALS for performing retroperitoneal nephrectomies in children when compared with controls undergoing open surgery in terms of safety, operative time, blood loss, opoid requirements, the duration of hospital stay and complications. CHILDREN AND METHODS: Computer-assisted retroperitoneoscopic nephrectomy was undertaken in ten consecutive children, mean age at the time of surgery 6.4 (SD ± 4.5) years, and compared with a retrospectively collected control group of all other children, mean age 3.9 (SD ± 4.6) years, who underwent the same procedure by conventional open surgery between the years 2005 and 2009. The endpoint of the study was 1 month postoperatively. RESULTS: Nephrectomies were performed in all the children and no child was excluded from the study. There was no per-operative complication in any of the groups. The median (range) operative time was 202 (128-325) and 72 (44-160) min for the CALS and open group, respectively. The blood loss was minimal (<20 ml) for all the patients. The postoperative opoid requirements did not differ. The median (range) postoperative hospital stay was 1 (1-4) and 2 (1-7) days for the CALS and the open group, respectively. One complication in the form of an urinoma appeared 5 days after surgery in the CALS group. CONCLUSION: Computer-assisted retroperitoneoscopic nephrectomy is a safe, feasible and effective procedure in children. Even though operative times are longer the patients benefit from the lower morbidity, improved cosmetics and shorter hospitalization associated with the minimally invasive approach. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Paediatric surgery, da Vinci Surgical System, Robotic surgery, Children, Nephrectomy, Computer-assisted
in
Pediatric Surgery International
volume
27
issue
7
pages
761 - 767
publisher
Springer
external identifiers
  • wos:000291694400016
  • pmid:21327553
  • scopus:79961173685
ISSN
1437-9813
DOI
10.1007/s00383-011-2860-1
language
English
LU publication?
yes
id
450b5c1a-9576-4739-9c7f-b6439bcd2714 (old id 1831729)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21327553?dopt=Abstract
http://link.springer.com/article/10.1007%2Fs00383-011-2860-1
date added to LUP
2011-03-01 17:09:02
date last changed
2017-01-01 05:28:46
@article{450b5c1a-9576-4739-9c7f-b6439bcd2714,
  abstract     = {PURPOSE: Computer-assisted laparoscopic surgery (CALS) in children is increasingly used and has proven to be feasible and safe. However, its full potential remains unclear and clinical comparative studies hardly exist. The aim of this study was to prospectively evaluate our experience with CALS for performing retroperitoneal nephrectomies in children when compared with controls undergoing open surgery in terms of safety, operative time, blood loss, opoid requirements, the duration of hospital stay and complications. CHILDREN AND METHODS: Computer-assisted retroperitoneoscopic nephrectomy was undertaken in ten consecutive children, mean age at the time of surgery 6.4 (SD ± 4.5) years, and compared with a retrospectively collected control group of all other children, mean age 3.9 (SD ± 4.6) years, who underwent the same procedure by conventional open surgery between the years 2005 and 2009. The endpoint of the study was 1 month postoperatively. RESULTS: Nephrectomies were performed in all the children and no child was excluded from the study. There was no per-operative complication in any of the groups. The median (range) operative time was 202 (128-325) and 72 (44-160) min for the CALS and open group, respectively. The blood loss was minimal (&lt;20 ml) for all the patients. The postoperative opoid requirements did not differ. The median (range) postoperative hospital stay was 1 (1-4) and 2 (1-7) days for the CALS and the open group, respectively. One complication in the form of an urinoma appeared 5 days after surgery in the CALS group. CONCLUSION: Computer-assisted retroperitoneoscopic nephrectomy is a safe, feasible and effective procedure in children. Even though operative times are longer the patients benefit from the lower morbidity, improved cosmetics and shorter hospitalization associated with the minimally invasive approach.},
  author       = {Anderberg, Magnus and Clementson Kockum, Christina and Arnbjörnsson, Einar},
  issn         = {1437-9813},
  keyword      = {Paediatric surgery,da Vinci Surgical System,Robotic surgery,Children,Nephrectomy,Computer-assisted},
  language     = {eng},
  number       = {7},
  pages        = {761--767},
  publisher    = {Springer},
  series       = {Pediatric Surgery International},
  title        = {Paediatric computer-assisted retroperitoneoscopic nephrectomy compared with open surgery.},
  url          = {http://dx.doi.org/10.1007/s00383-011-2860-1},
  volume       = {27},
  year         = {2011},
}