A review of our first 100 cases of laparoscopic nephrectomy: defining risk factors for complications

Abstract

Objective To present the complications from our first staghorn calculi, polycystic kidney disease, and xanthogranulomatous pyelonephritis. While there was no 100 cases of laparoscopic nephrectomy, a technically demanding procedure requiring lengthy experience, discernible decline in the decrease in complications with experience, operative duration decreased from a and to define the risk factors. Patients and methods Indications for laparoscopic nephmean of 204 min for the first 20 cases to 108 min for the last 20. Complications and conversions were more rectomy included patients requiring nephrectomy for benign pathology and those requiring nephroureterecclosely associated with diagnosis than with the surgeon's experience. tomy for upper tract transitional cell carcinoma confined to the upper ureter and/or renal pelvis. AllConclusion Laparoscopic nephrectomy and nephroureterectomy can be undertaken for a variety of indications patients were operated on by one surgeon (D.A.T.) via a transperitoneal route and data on diagnosis, outwith reasonable complication and conversion rates. Although inflammatory conditions increase the diBcome and complications collected prospectively. Results The overall complication rate was 18%, of which culty of these procedures, we feel that patients requiring nephrectomy for benign disease should be oCered 3% were major and 15% minor complications. Five cases were converted to open surgery electively. a trial of laparoscopic surgery. Keywords Laparoscopy, nephrectomy, complications Complications and conversions were associated with a history of pyonephrosis, previous renal surgery, Several risk factors have been associated with compli-

Nonrandomized Comparison of Open Flank versus Laparoscopic Nephrectomy in 249 Patients with Benign Renal Disease

“…These results are consistent with smaller series reported by other authors who compared open and laparoscopic nephrectomy [13, 14, 15, 16]. However, published reports on laparoscopic nephrectomy have also been retrospective and often with a small number of patients or not comparative [13, 14, 15, 16, 18, 19, 20, 21]. Therefore, we attempted to reduce bias by increasing the number of patients studied (n = 249) and the observation period (5 years).…”

“…Laparoscopic nephrectomy for benign disease is usually performed at specialized centers since this operative technique is associated with a certain learning curve and the number of patients who require nephrectomy for benign disease is relatively small [12, 13, 14, 15, 16, 18, 19, 20, 21]. In the case of any new surgical procedure, there must be a critical assessment of the technique, related complications and the outcome.…”

“…A conversion to open surgery was necessary in 9 patients (8.5%). In a third study a total of 100 patients who had undergone a laparoscopic nephrectomy were reported by Keeley and Tolley [20]in 1998. In that series the complication rate was 18% with a conversion rate of 5%.…”

Laparoscopic Radical Nephrectomy

“…The conversion rate to open surgery was 3.8% usually for either hemorrhage or difficulties in dissection. Keeley and Tolley [17]has identified risk factors for conversion in simple nephrectomy as previous renal surgery and renal inflammatory conditions. The complication rate was 9.6%, which again is consistent with published series and represents 16 perioperative complications (table 1) [16].…”

Comparison of transperitoneal laparoscopic nephrectomy outcomes in atrophic and hydronephrotic kidneys

“…[9] LN can be safely applied both in adults, and pediatric patients as well. [10] Even though some publications have reported shorter operative, and hospitalization times, and lower conversion rates for retroperitoneal approach, choice of the laparoscopic technique is related basically to training, experience, and preference of the surgeon. [11] In simple LNs performed for benign conditions ensuing complications, and outcomes have been effected by various factors.…”