[Laparoscopic nephrectomy in geriatric patients: comparison with conventional nephrectomy].

Area of Science:

• Urology
• Minimally Invasive Surgery
• Geriatric Surgery

Background:

• Open nephrectomy has been the traditional approach for kidney removal.
• Geriatric patients present unique challenges for surgical interventions.
• Assessing the safety and efficacy of laparoscopic nephrectomy in this demographic is crucial.

Purpose of the Study:

• To compare the outcomes of laparoscopic nephrectomy versus open nephrectomy in geriatric patients.
• To evaluate the benefits of the laparoscopic approach in terms of perioperative and postoperative parameters.
• To determine the preferred surgical technique for nephrectomy in elderly individuals.

Main Methods:

• A retrospective analysis of 249 patients undergoing nephrectomy for benign renal disease since 1993.
• Comparison of clinical parameters between 131 patients who underwent laparoscopic nephrectomy and 118 who had open nephrectomy.
• Analysis of outcomes across different age groups within both surgical cohorts.

Main Results:

• Laparoscopic and open nephrectomy showed similar operative times and hemoglobin levels.
• Laparoscopic nephrectomy demonstrated significantly less blood loss, lower transfusion rates, reduced analgesic use, shorter hospital stays, and faster convalescence.
• Complication rates were comparable, though elevated in patients aged 75-84; 30-day mortality was 1.7% in the open nephrectomy group.

Conclusions:

• Laparoscopic nephrectomy provides equivalent operative results with improved postoperative outcomes compared to open nephrectomy.
• Geriatric patients experience substantial benefits from the laparoscopic approach, including reduced morbidity.
• Laparoscopic nephrectomy should be considered the primary surgical technique for kidney removal in geriatric patients.