The pediatric caliceal diverticulum: diagnosis and laparoscopic management.
J Endourol
; 18(7): 668-71, 2004 Sep.
Article
em En
| MEDLINE
| ID: mdl-15597659
ABSTRACT
PURPOSE:
To describe the laparoscopic management of anterior caliceal diverticula in pediatric patients and to emphasize the importance of intraoperative retrograde pyelography for the diagnosis of symptomatic lesions when preoperative radiologic evaluation is inconclusive. PATIENTS ANDMETHODS:
We performed laparoscopic transperitoneal excision of a large symptomatic caliceal diverticulum in three patients. Ultrasonography was consistent with a cyst, and a CT scan did not show layering on delayed images. Prior to surgical intervention, we localized the diverticulum by cystoscopy and fluoroscopic retrograde ureteropyelography.RESULTS:
Complete ablation of the caliceal diverticulum cavity was achieved in all cases without open conversion. The mean operative time was 134 minutes. Blood loss was minimal in all cases. The mean hospital stay was 37 hours. There were no intraoperative or postoperative complications. Because the preoperative studies were consistent with large anterior cysts, we found retrograde ureteropyelography as an adjunct to laparoscopic surgery invaluable to identify the patent diverticular neck.CONCLUSION:
Patients with a large, symptomatic Type 2 caliceal diverticulum with thin overlying parenchyma are ideal candidates for laparoscopic intervention. The laparoscopic technique of caliceal diverticulum ablation in the pediatric population is feasible in appropriate patients.
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Bases de dados:
MEDLINE
Assunto principal:
Urografia
/
Divertículo
/
Laparoscopia
/
Nefropatias
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Limite:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
Idioma:
En
Revista:
J Endourol
Assunto da revista:
UROLOGIA
Ano de publicação:
2004
Tipo de documento:
Article
País de afiliação:
Estados Unidos