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[Retroperitoneal laparoscopic nephrectomy fo polycystic kidney: preliminary results]
Xavier Gamé1, Christophe Vaessen, Marc Mouzin
1Servce d'Urologie, d'Andrologie et de Transplantation Rénale, 31403 Toulouse, France. xaviergame@hotmail.com
Objectives:
To evaluate the morbidity and mortality of retroperitoneal laparoscopic nephrectomy for polycystic kidney.
Material And Methods:
Between June 2000 and March 2002, seven retroperitoneal laparoscopic nephrectomies for polycystic kidney were performed in six patients (three men, three women) with a mean age of 52.8 years. All patients presented end-stage renal failure treated by haemodialysis in five cases and by renal transplantation in one case. The ASA score was 2 in four cases and 3 in two cases. The indication for surgery was preparation for renal transplantation, episodes of macroscopic haematuria and pain in three cases, hypertension poorly controlled by medical treatment in two cases, preparation for renal transplantation in one case and pain associated with restrictive respiratory syndrome due to compression in one case.
Results:
The mean operating time was 4 hours 35 minutes, and the mean blood loss was 400 ml. There were no intraoperative or perioperative deaths. An early postoperative complication occurred in two cases. The mean hospital stay was 11 days, with a mean stay of 2.4 days in the postoperative intensive care unit. No late complications were observed with a mean follow-up of 14 months. Preoperative pain, episodes of haematuria, hypertension and signs of compression resolved in each case.
Conclusion:
Laparoscopic nephrectomy for polycystic kidney is a technique that can be performed via a retroperitoneal approach without manual assistance and with low morbidity.