Background For 29 years, Laparoscopic Nephrectomy has steadily established itself as a technique for kidney excision. Patients as well as surgeons appreciate the benefits of this less invasive technique. Although the morbidity and mortality of this minimally invasive technique are relatively low, the risks it entails must be taken into account seriously. The purpose of this study is to evaluate and compare the intra- and postoperative morbidity and mortality factors connected to Laparoscopic Transperitoneal Nephrectomy for inflammatory kidney versus tumoral kidney according to the Clavien–Dindo classification. Methods A prospective comparative mono-centric study was carried out over a period of 24 months (January 2018–January 2020) on patients having benefited from a Laparoscopic Transperitoneal Nephrectomy for Inflammatory (Group 1) or Tumoral (Group 2) causes. Postoperative morbidity and mortality were assessed according to the Dindo–Clavien classification. Results This study included 60 patients. Group 1 consisted of 32 patients (median age: 50.4 years) and Group 2 of 28 patients (median age: 61 years). Drainage of inflammatory kidneys was done preoperatively by nephrostomy drain (11 cases) and double J probe (3 cases). The mean operating time was longer in Group 1 (234 vs 186.8 min, p = 0.1). The conversion rate was statistically significant in Group 1 (6 vs 1, p < 0.05). The rate of Grade 1 complications is very significant in Group 1: ileus (6 vs 2, p = 0.02), postoperative antibiotic therapy (26 vs 3, p = 0.001) and infection of the wall (4 vs 0, p < 0.001). The rate of severe complications (Clavien ≥ 3) was the same in the two groups. The average length of hospital stay was higher in Group1. Conclusion Our work (study) showed a higher rate of severe complications in Laparoscopic nephrectomies for inflammatory causes.
Zinner syndrome is a rare congenital malformation related to an abnormality in the development of the Wolffian duct, the clinical picture of which consists of a triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and obstruction of the ejaculatory duct. Chronic perineoscrotal pain may be an indication of the diagnosis of Zïnner syndrome to some extent. We report the observation of a 23-year-old patient, married and father of one child, who presented with chronic perineo-scrotal pain revealing on morphological assessment (ultrasound, uroscanner, prostatic MRI) a cystic formation of the seminal vesicle, left renal agenesis with an empty left renal compartment. Given the patient's refusal of any surgical procedure, treatment consisted of echo-guided puncture of the seminal vesicle cyst bringing back 30 cc of a seroviscous liquid whose analysis revealed spermatozoa, without atypical cells, compatible with a cyst. The clinical evolution was marked by a progressive remission of the scrotal pain with a delay of several months.
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