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Laparoscopic and open surgical nephrectomy for xanthogranulomatous pyelonephritis
Herkanwal S Khaira1, Rajal B Shah, J Stuart Wolf
1Department of Urology, University of Michigan, Ann Arbor, MI 48109, USA.
Journal of Endourology
|September 30, 2005
Summary
Laparoscopic nephrectomy for xanthogranulomatous pyelonephritis (XGP) is feasible but challenging. While complication rates were similar, laparoscopy may offer reduced postoperative morbidity compared to open surgery for XGP.
Area of Science:
- Urology
- Surgical Oncology
- Nephrology
Background:
- Xanthogranulomatous pyelonephritis (XGP) is a severe chronic kidney infection.
- Nephrectomy is the standard treatment for XGP.
- Laparoscopic nephrectomy is challenging due to inflammation associated with XGP.
Purpose of the Study:
- To compare the outcomes of laparoscopic versus open nephrectomy for XGP.
- To evaluate the feasibility and safety of laparoscopic surgery for XGP.
Main Methods:
- Retrospective chart review of adult patients diagnosed with XGP between 1997 and 2003.
- Data collected included preoperative presentation, operative details, and postoperative recovery.
- Comparison of laparoscopic (n=3) and open (n=8) nephrectomy groups.
Main Results:
- XGP was suspected preoperatively in all patients.
- Laparoscopic group: 1 major complication (conversion to open).
- Open group: 2 major and 3 minor complications. Longer hospitalization (13.7 vs 4.7 days) and higher narcotic use in the open group.
Conclusions:
- Laparoscopic nephrectomy is a possible, though challenging, option for select XGP cases.
- Intraoperative and postoperative complication rates were comparable between laparoscopic and open surgery.
- Completed laparoscopic procedures may be associated with decreased postoperative morbidity, warranting further investigation.