Lumbotomy approach for upper urinary tract surgeries in adolescents: Feasibility and challenges

Objective: The objective of this study was to assess the feasibility and challenges in a lumbotomy approach for performing upper urinary tract surgeries in adolescent children. Material and methods: Fifty-five adolescent children underwent various upper urinary tract surgeries from 2000 to 2012. In all patients, the kidneys and ureters were approached via a lumbotomy incision. The patients' characteristics were analysed from the hospital charts. Intraoperative and postoperative details were gathered from individual case files. Data were collected regarding: age, weight, gender, diagnosis, surgical procedure, anaesthetic details, any intraoperative problems encountered, postoperative pain, time to oral feed, length of hospitalisation and any complications. Results: The median age at surgery was 14 years (range 10-19). There were 42 boys and 13 girls. Median weight was 41 kg (range 28-52 kg). Surgeries performed were pyeloplasty, pyelolithotomy, nephroureterectomy and heminephrectomy. Mean duration of surgery was 80 min (range 60-130 min) with no special anaesthetic requirements. No intraoperative problems were encountered. In all patients, postoperative stay was uneventful with minimal analgesic requirements and oral feeding was started the very next day. There were no incision-related complications. Conclusions: A lumbotomy incision is technically easy and safe, even in adolescent children, as an approach for upper urinary-tract surgeries. (C) 2014 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.