Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2019; 7(10): 1169-1176
Published online May 26, 2019. doi: 10.12998/wjcc.v7.i10.1169
Retroperitoneoscopic approach for partial nephrectomy in children with duplex kidney: A case report
Di-Xiang Chen, Zi-Hao Wang, Shan-Jie Wang, Yue-Yue Zhu, Nan Li, Xian-Qiang Wang
Di-Xiang Chen, Xian-Qiang Wang, Department of Pediatrics, PLA General Hospital, Beijing 100853, China
Zi-Hao Wang, The Fourth Military Medical University, Xi’an 710032, Shannxi Province, China
Shan-Jie Wang, The Sixth People’s Hospital of Jinan Affiliated to Jining Medical School, Jinan 250200, Shandong Province, China
Yue-Yue Zhu, Southern Medical University, Guangzhou 510515, Guangdong Province, China
Nan Li, Department of Ultrasound Diagnosis, PLA General Hospital, Beijing 100853, China
Author contributions: Chen DX and Wang ZH contribute equally to this article and should be considered as co-first authors; Chen DX and Wang XQ performed the operation; Chen DX, Wang ZH, and Wang SJ designed this case report; Wang ZH and Wang XQ wrote this paper; Zhu YY and Li N was responsible for sorting the data.
Informed consent statement: Informed consent was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
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Corresponding author: Xian-Qiang Wang, MD, PhD, Attending Doctor, Department of Pediatric, PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China.
Telephone: +86-13522891848 Fax: +86-10-66938418
Received: January 4, 2019
Peer-review started: January 4, 2019
First decision: March 10, 2019
Revised: March 16, 2019
Accepted: March 26, 2019
Article in press: March 26, 2019
Published online: May 26, 2019
Processing time: 142 Days and 21.7 Hours

Renal duplication is a common deformity of the urinary system, with an incidence of approximately 1/125 in children. Symptomatic patients with hydronephrosis, vesicoureteral reflux, or incontinence may require surgical interventions. Laparoscopy and retroperitoneoscopy are the two main accesses for partial nephrectomy.


A 9-year-old child was admitted to the hospital for hydronephrosis of the left kidney. Ultrasonography showed that the left kidney was larger, approximately 12.6 cm × 6.3 cm × 5.5 cm in size, with visible separation of the pelvis and an obviously separated lower portion. The upper segment of the left ureter was dilated (approximately 2.6 cm in width), and no significant dilation was observed in the middle and upper segments. The right kidney and ureter were normal. Primary diagnosis was left renal duplication malformation and hydronephrosis. Retroperitoneal laparoscopic nephrectomy and ureterectomy were performed. Intraoperative exploration revealed a dilated pelvis and thin renal parenchyma at the lower pole of the left kidney. The upper left kidney was smaller than normal, and the pelvis and ureter were larger than normal. The renal artery was blocked for 40 min. A hemolock was used to clamp down the kidney ureter, and a drainage tube was retained in the retroperitoneal cavity. The operation was uneventful, and the estimated amount of blood loss was 100 mL. Total abdominal drainage amount was 116 mL. The drainage tube was removed on postoperative day (POD) 3 and the patient was discharged on POD6. The pathological diagnosis confirmed the atrophy of the renal parenchyma, the dilation of the renal pelvis, hydronephrosis, and ureteral cystic dilation.


The retroperitoneoscopic approach for partial nephrectomy is feasible and effective in selective pediatric patients with a duplex kidney.

Keywords: Retroperitoneoscopy, Duplex kidney, Nephrectomy, Pediatric, Case report

Core tip: Duplex kidney is a common congenital malformation of the urinary system in chil-dren, and most symptomatic patients should opt for surgical management. However, there is still some controversy on the applications of the translaparoscopic approach and retrolaparoscopic approach. We will discuss the advantages and disadvantages of both approaches in this case. These contents provide a basis for future research.