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Case Reports
. 2019 May 26;7(10):1169-1176.
doi: 10.12998/wjcc.v7.i10.1169.

Retroperitoneoscopic approach for partial nephrectomy in children with duplex kidney: A case report

Di-Xiang Chen  1 , Zi-Hao Wang  2 , Shan-Jie Wang  3 , Yue-Yue Zhu  4 , Nan Li  5 , Xian-Qiang Wang  6
Affiliations
Case Reports

Retroperitoneoscopic approach for partial nephrectomy in children with duplex kidney: A case report

Di-Xiang Chen et al. World J Clin Cases. .

Abstract

Background: Renal duplication is a common deformity of the urinary system, with an incidence of approximately 1/125 in children. Symptomatic patients with hydronephrosis, vesicoureteral reflux, or incontinence may require surgical interventions. Laparoscopy and retroperitoneoscopy are the two main accesses for partial nephrectomy.

Case summary: A 9-year-old child was admitted to the hospital for hydronephrosis of the left kidney. Ultrasonography showed that the left kidney was larger, approximately 12.6 cm × 6.3 cm × 5.5 cm in size, with visible separation of the pelvis and an obviously separated lower portion. The upper segment of the left ureter was dilated (approximately 2.6 cm in width), and no significant dilation was observed in the middle and upper segments. The right kidney and ureter were normal. Primary diagnosis was left renal duplication malformation and hydronephrosis. Retroperitoneal laparoscopic nephrectomy and ureterectomy were performed. Intraoperative exploration revealed a dilated pelvis and thin renal parenchyma at the lower pole of the left kidney. The upper left kidney was smaller than normal, and the pelvis and ureter were larger than normal. The renal artery was blocked for 40 min. A hemolock was used to clamp down the kidney ureter, and a drainage tube was retained in the retroperitoneal cavity. The operation was uneventful, and the estimated amount of blood loss was 100 mL. Total abdominal drainage amount was 116 mL. The drainage tube was removed on postoperative day (POD) 3 and the patient was discharged on POD6. The pathological diagnosis confirmed the atrophy of the renal parenchyma, the dilation of the renal pelvis, hydronephrosis, and ureteral cystic dilation.

Conclusion: The retroperitoneoscopic approach for partial nephrectomy is feasible and effective in selective pediatric patients with a duplex kidney.

Keywords: Case report; Duplex kidney; Nephrectomy; Pediatric; Retroperitoneoscopy.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Intravenous pyelography. A: 10 min, B: 40 min.
Figure 2
Figure 2
Magnetic resonance imaging of the patient (T2). The left renal pelvis and ureter were significantly dilated, the widest part of the ureter was approximately 29 mm, and the left ureter had stenosis in the middle part.
Figure 3
Figure 3
Trocar diagram. Point C is the endoscopic port.
See this image and copyright information in PMC

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