[Complications after thoraco-retroperitoneal nephrectomy (author's transl)]

We are of the opinion that for large kidney tumors in the upper region as the afflicted venous portions, the most advantageous incision is a thoraco-retro- peritoneal one. It allows the surgeon total freedom of movement and ensures reliable radical tumor-nephrectomy, as well as reconstruction possibilities in the large vessels. Of course, use of this incision is not without complications. They appear, however, not as often as opponents of this method would suppose. There are other statistics to support our convictions (4). From the check-ups of our thoraco-retroperitoneal nephrectomy patients, we are able to surmise the following: - The post operative mortality rate is not increased with this method. The cause for the mortalities are, as far as one can tell, old age and/or a generally poor condition piror to nephrectomy. - Post operative complications due to access though the thorax are very few. Not one patient had to be re-operated, punctured, or treated using suction drainage. No respiratory difficulties were observed. - Post operative complications from the wound were naturally relative to the extent of the incision. It was also here unnecessary to perform a second operation except in one case of a retroperitoneal hematoma from heparinization. This complication was not the result of this particular incision.