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Laparoscopic nephrectomy for inflammatory renal conditions.
B Shekarriz1, M V Meng, H F Lu
1Department of Urology, University of California-San Francisco School of Medicine, San Francisco, California 94143-0738, USA.
The Journal of Urology
|November 7, 2001
Summary
Laparoscopic nephrectomy is safe for inflammatory renal conditions, though conversion rates and operative times may be higher. Technical modifications can improve outcomes in these challenging cases.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Nephrology
Background:
- Perirenal fibrosis from inflammatory/infectious renal conditions complicates laparoscopic surgery.
- The efficacy of laparoscopy for these conditions is debated.
Purpose of the Study:
- To determine if laparoscopy for inflammatory renal conditions has higher morbidity than for other benign renal conditions.
- To discuss technical modifications for improved laparoscopic outcomes in inflammatory renal cases.
Main Methods:
- Retrospective review of laparoscopic nephrectomies for inflammatory/infectious renal conditions (1998-2000).
- Comparison with matched cases of laparoscopic nephrectomy for other benign renal conditions.
- Transperitoneal approach with specimen morcellation.
Main Results:
- Successful laparoscopic nephrectomy in 83% of inflammatory cases vs. 100% of benign cases.
- Higher mean blood loss (155 vs. 59 ml) and operative time (284 vs. 226 min) in inflammatory cases, though not statistically significant.
- Longer postoperative hospital stay in inflammatory cases (4.1 vs. 3 days), also not statistically significant.
Conclusions:
- Laparoscopic nephrectomy is generally safe for inflammatory renal conditions.
- Expect potentially higher conversion rates and longer operative times, with early conversion sometimes necessary.
- Laparoscopic approach offers similar advantages for inflammatory and benign renal conditions.