Complicaciones en cirugía laparoscópica renal en la edad pediátrica: análisis de nuestra experiencia y revisión de la literatura

introduction: the development of the minimally invasive surgery in pediatric age has been slower than in the adult age since their advantages are not so clear. the learning curve and the complications presented during this period, as well as the type of material used has been the factors that have contributed to this fact. objective: we collected our experience and the complications presented in renal laparoscopic exegesis surgery, adding a review of the published literature to date. materials and methods: retrospective study of our clinical cases in that we practiced laparoscopic renal exegesis surgery. we collected 56 cases from january 2003, when it was implanted, to september 2008. we had 36 boys (64%) and 20 girls (36%). the mean age was 3.6 years. we analyzed principal diagnosis, the situation that conducted to the surgery and the type of surgery performed, time of surgery, hospital stay and complications with their solution. the results were analyzed by the statistical program spss？ (spsscorp, chicago, illinois). the literature review was practiced in medline, embase and cochrane database. the selected works were reviewed by two investigators. series containing adults were excluded. results: we perfomed 42 nephrectomies (75%), 13 heminephrectomies (23%) and 1 quistectomy (2%). 5 cases (9%) were done by retroperitoneoscopy and 51 cases (91%) transperitoneally. the mean operative time was 118 min, range 25-240 min, for nephrectomies; 192 min, range 75-300 min, for partial nephrectomies, 111min. (60-160) for nephroureterectomies and 240 min for quistectomía. the mean hospital stay was 3.18 min (2-6) days for nephrectomies; 5.91 (3-11) days for partial nephrectomies, 3 days (2-4) for nephroureterectomies and 6 days for the quistectomy. we had 8 complications (14%): 2 conversions for bledding and technical difficulty and 6 postoperative complications (3 were minor complications, postoperative fever and 3 mayor (2 urinomas and one pseudoaneurism, requiring 2 interv