Open surgery versus retroperitoneal laparoscopic nephrectomy for renal tuberculosis: a retrospective study of 120 patients

Abstract

BackgroundLaparoscopic renal surgery has been widely used in the treatment of renal diseases. However, there is still little research about its application in addressing renal tuberculosis. The purpose of this study is to retrospectively investigate the surgical results of laparoscopic and open surgery for nonfunctional tuberculous kidneys.MethodsBetween May 2011 and June 2016, 120 nephrectomies were performed in patients with a nonfunctional tuberculous kidney. Of these, 69 patients underwent retroperitoneal laparoscopic nephrectomy, and 51 patients underwent open nephrectomy. Data about the patients’ characteristics and surgical outcomes were collected from their electronic medical records. Outcomes were compared between these two groups.ResultsOur results showed that a number of renal tuberculosis patients presented no significant symptoms during their disease. Lower urinary tract symptoms (LUTS) were the most common at a rate of 73/120, followed by flank pain or accidently discovery (66/120), urine abnormality (30/120) and fever (27/120). Patients who underwent open surgery were similar to laparoscopic patients with regard to sex, BMI, location, previous tuberculous history, grade, anemia, adhesion, hypertension, diabetes and preoperative serum creatinine level, but were generally older than laparoscopic patients. There were no significant differences between open and laparoscopic surgery in estimated blood loss, transfusion, postoperative hospital days and perioperative complication rate. However, the median operation time of laparoscopic operation was much longer than open surgery (180 [150–225] vs 135 [120–165] minutes, P < 0.01). Seven of the 69 laparoscopic operations were converted to open surgery because of severe adhesions.ConclusionLaparoscopic nephrectomy is as an effective treatment as open surgery for a nonfunctional tuberculous kidney, although it requires more time during the surgical procedure. No significant differences in other surgical outcomes were observed.

Diagnosis and treatment of epididymal tuberculosis: a review of 47 cases

“…The number of tuberculosis patients in China accounted for 10-12% of the total number of tuberculosis patients in the world, ranking second in the world (Glaziou, Floyd & Raviglione, 2018;Zhang et al, 2016). People in Gansu Province of China have a high incidence of tuberculosis and are relatively delayed in seeking medical care (Zhang et al, 2016). The presentation of tuberculosis is increasingly atypical.…”

Urinary Tract Tuberculosis

“…In UTTB, a history of pulmonary TB is present in 17.7-25.8% [14][15][16]. The time interval between the onset of primary pulmonary TB and development of GUTB has a mean interval of 3-10 years in more than 50% of patients [14,15].…”

“…The time interval between the onset of primary pulmonary TB and development of GUTB has a mean interval of 3-10 years in more than 50% of patients [14,15]. In frequency, renal involvement is the most common finding following by ureteric and bladder involvement [16]. Simultaneous involvement of kidney, ureter, and bladder has been reported until a 25.8% [15,16].…”

“…In frequency, renal involvement is the most common finding following by ureteric and bladder involvement [16]. Simultaneous involvement of kidney, ureter, and bladder has been reported until a 25.8% [15,16]. The incidence of active pulmonary TB concurrent with UTTB varied from 10 to 25.8%.…”

“…The standard treatment for a unilateral nonfunctional kidney secondary to renal TB is a nephrectomy combined with anti-TB therapy [16]. The patients that end up in nephrectomy have an advanced stage [13,37].…”