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Articles

Perioperative morbidity of paediatric laparoscopic nephrectomy by transperitoneal and retroperitoneal approaches- any difference?

, , , & ORCID Icon
Pages 257-261 | Received 18 Jan 2021, Accepted 17 Mar 2021, Published online: 07 Apr 2021
 

Abstract

Aim

Minimal invasive approaches for paediatric nephrectomy include transperitoneal (TP) and retroperitoneal (RP); both having advantages and disadvantages. We aimed to ascertain if there was any difference in perioperative morbidities between these two approaches.

Methods

We performed a retrospective review of laparoscopic TP and RP nephrectomies performed in our institution over 10 years from May 2009 till May 2019. Outcome measures included intraoperative complications, prolonged requirement of opioid analgesics (more than 24 h), hospital stay, incidence of wound infection and urinary tract infections. Data were analysed using Fisher’s exact test and Mann Whitney test.

Results

A total of 152 nephrectomies were performed in 139 patients; 81 were TP and 71 were RP. Age ranged from 8 months to 16 years. Median hospital stay was 2 days in both groups. There were no intraoperative complications. Outcome measures were sub-categorised as follows. Requirement of opioid analgesia for more than 24 h was documented in 2 patients in each group, leading to longer hospital stay of 3 days. A febrile urinary tract infection requiring antibiotics was detected in 4; 1 in TP and 3 in RP. Wound infection requiring antibiotics occurred in 1 patient (in RP group). No statistically significant difference was found between the two groups in any of the subcategories.

Conclusion

TP and RP nephrectomy have similar perioperative morbidity. The decision to utilise either approach should be dependent on the surgeon’s skills and experience and appropriately tailored to individual patient needs

SUBJECT CLASSIFICATION CODES::

Disclosure statement

No potential conflict of interest was reported by the author(s).

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