Laparoscopic simple nephrectomy: perioperative outcomes at Srinagarind Hospital

Laparoscopic urology is a minimally invasive alternative to open surgery, especially laparoscopic simple nephrectomy for benign disease such as KUB stone.

To evaluate the efficacy and perioperative outcomes of laparoscopic simple nephrectomy at Srinagarind Hospital.

Analyzed the demographic and perioperative data of 78 consecutive patients who underwent laparoscopic simple nephrectomy.

Mean age was 54.1. The indications included non-functioning kidney (64) and infection (14). Surgery averaged 118.37 minutes. In 38 and 40 respective cases, a transperitoneal and retroperitoneal approach was used. Intraoperative complications (13; 16.7%) included 10 bleeding, 2 diaphragmatic injuries and 1 pancreatic injury. Six cases (10.3%) were converted to open surgery: 5 for massive adhesion and 1 for uncontrolled bleeding. Mean estimated blood loss was 170.99 ml. Post-operative complications included: 8 cases of prolonged ileus and 5 wound infections. Mean post-operative analgesia was 14.0 mg morphine: mean pain score at post-operative day 1 6.20. Mean time to oral intake was 1.48 days, and post-operative period 4.63 days. Retroperitoneal access was associated with: shorter operative time (103.83 vs. 133.68 minutes, p = 0.008); a better result vis-a-vis post-operative ileus (1 vs. 7, p = 0.021); and shorter time to oral intake than transperitoneal route (1.20 vs. 1.79 days, p = 0.004).

Vis-a-vis reducing pain, faster recovery and improved cosmetics laparoscopic nephrectomy by a skilled surgeon via retroperitoneal approach is preferred for benign diseases.