Comparative Study Of Transumbilical Single-site Laparoscopy And Conventional Laparoscopy In Child Nephrectomy

Objective: To retrospectively analyze the clinical data of transumbilical laparoendoscopic single site nephrectomy and conventional laparoscopic nephrectomy,analyze and summarize the surgical experience,and explore the safety and feasibility of single-site laparoscopic technique in children’s nephrectomy,as well as the cosmetic of surgical scar.Methods: A retrospective analysis about 39 cases who had nephrectomy from December 2014 to September 2019 was performed.All collected cases were operated by a same group of doctors in the second ward of the Department of Pediatric Surgery of the First Affiliated Hospital of Guangxi Medical University,including 22 cases of conventional laparoscopic nephrectomy,and17 cases of transumbilical laparoendoscopic single site nephrectomy.The differences between gener-al data,intraoperative and postoperative case data,and postoperative follow-up data were summarized and discussed.Results: Except one case of pelvic heterotopic nephrectomy in the transumbilical laparoendoscopic single site surgery group,bladder repair was performed due to bladder damage during the operation,the rest of the operations were successfully completed.There was no significant difference between two groups in terms of gender,age,BMI,disease structure composition ratio,average operation time,average bleeding volume,intraoperative blood gas analysis,drainage tube removal time(P>0.05).However,between the two operation groups,there were significant difference between digestive system function recovery time,length of hospital stays,and postoperative scar evaluation(P<0.05).The transumbilical laparoendoscopic single site surgery group was significantly shorter in digestive system function recovery time and hospital stays than the standard group,and the incision appearance of patients was significantly better than that of the standard group.Conclusion: Transumbilical laparoendoscopic single site surgery is safe and feasible in the nephrectomy of children,and has a better incision appearance.By rationally controlling the indications for surgery,the safety of transumbilical laparoendoscopic single site surgery in children’s nephrectomy can be further improved.For repeated urinary tract infections before surgery resulting in severe renal non-functioning hydronephrosis and renal dysplasia,conventional laparoscopic should be chosen for the surgery.