背景在这项研究中,我们的目的是报告单中心腹腔镜小儿泌尿外科手术的经验.我们旨在确定各种泌尿外科和泌尿生殖系统腹腔镜手术的可行性以及提高手术成功率的技巧。方法回顾性分析2018年6月至2023年2月在我们的诊所接受腹腔镜泌尿系统和/或泌尿生殖系统手术以诊断和治疗目的的98例患者的数据。所有手术均由同一手术团队进行。腹腔镜手术包括睾丸固定术,性腺切除术,阴道成形术,子宫切除术,肾盂成形术,肾切除术/肾部分切除术,输尿管膀胱造口术,膀胱憩室切除术,肾囊肿切除术,输尿管近端结石清除术,卵巢切除术,卵巢扭曲,oophoroopexy,和用于诊断目的的淋巴结切除。患者的手术计划是基于小儿肾脏病的决定,儿科内分泌学,儿科肿瘤科和多学科理事会。患者的人口统计学特征,手术适应症,术中数据,以及术后病理诊断和并发症,被记录下来。所有患者均行腹膜入路。手术持续时间从麻醉记录中获得,并定义为从手术切口开始到皮肤切口闭合的时间。结果患者,男性54人,女性44人。中位年龄为7.8岁。在我们的患者中观察到除Clavien-Dindo分类的1级以外的并发症。随着对不同类型的手术进行分析,估计了平均手术时间.结论在小儿泌尿外科中,腹腔镜手术应由经验丰富的外科医师进行。在准备腹腔镜手术以最大程度地减少技术和人体工程学问题时,考虑儿科患者大小的差异至关重要。我们相信每个手术都有其特定的技巧,这些应该是腹腔镜培训的一部分。此外,开发和分享这些信息对儿科泌尿科医师非常有用。
Background In this study, we aim to report our single-center experience with laparoscopic pediatric urological surgeries. We aim to determine the feasibility of various urological and urogenital laparoscopic procedures and the tricks that increase surgical success. Methodology Data from 98 patients who underwent laparoscopic urological and/or urogenital procedures for diagnostic and therapeutic purposes in our clinic between June 2018 and February 2023 were retrospectively analyzed. All surgeries were performed by the same surgical team. Laparoscopic procedures included orchidopexy, gonadectomy, vaginoplasty, hysterectomy, pyeloplasty, nephrectomy/partial nephrectomy, ureteroneocystostomy, bladder diverticulum excision, renal cyst excision, proximal ureter stone removal, oophorectomy, ovarian detorsion, oophoropexy, and lymph node excision for diagnostic purposes. The surgical planning of the patients was based on the decisions of the pediatric nephrology, pediatric endocrinology, and pediatric oncology departments and the multidisciplinary council. Demographic characteristics of the patients, surgical indications, and intraoperative data, as well as postoperative pathological diagnoses and complications, were recorded. All patients underwent a transperitoneal approach. The duration of the operation was obtained from anesthesia records and defined as the time from the beginning of the surgical incision to the closure of the skin incision. Results Of the patients, 54 were males and 44 were females. The median age was 7.8 years. No complications other than grade 1 according to the Clavien-Dindo classification were observed in our patients. As different types of surgeries were analyzed, the mean operative duration was estimated. Conclusions The laparoscopic method should be performed by surgeons experienced in advanced surgeries in pediatric urology. It is critical to consider the difference in the size of pediatric patients in preparation for laparoscopic surgery to minimize technical and ergonomic problems. We believe that each surgery has its specific tricks and that these should be a part of laparoscopy training. Moreover, developing and sharing this information would be very useful for pediatric urologists.