Laparoscopic Transperitoneal Nephrectomy in Non-functioning Severe Hydronephrotic Kidneys With or Without Renal Stone

Area of Science:

• Urology
• Nephrology
• Surgical Oncology

Background:

• Severe hydronephrosis in non-functional kidneys often necessitates surgical intervention.
• The impact of coexisting nephrolithiasis (kidney stones) on laparoscopic simple nephrectomy outcomes is not fully elucidated.
• Indications for nephrectomy include persistent pain, recurrent infections, and refractory hypertension.

Purpose of the Study:

• To evaluate the effect of nephrolithiasis on laparoscopic simple nephrectomy results in patients with severe hydronephrotic, non-functional kidneys.
• To compare outcomes between patients with and without kidney stones undergoing the procedure.

Main Methods:

• A retrospective study included 43 patients with severe hydronephrosis and renal function <10% (assessed by DMSA scintigraphy).
• Patients were divided into two groups: Group 1 (with stones) and Group 2 (without stones).
• Comparison included demographics, operation duration, pre/postoperative labs (hemoglobin, creatinine), complications, transfusion needs, and hospitalization duration.

Main Results:

• No statistically significant differences were found in operation duration, hospitalization, or hemoglobin change between groups.
• Postoperative complications occurred in 48.8% of all patients (13 in Group 1, 8 in Group 2).
• The higher rate of postoperative complications in the stone group (Group 1) was statistically significant (p<0.01).

Conclusions:

• Laparoscopic simple nephrectomy yields similar functional and operative outcomes for severe hydronephrotic kidneys, regardless of stone presence.
• Nephrolithiasis significantly increases the risk of postoperative complications following laparoscopic simple nephrectomy in this patient cohort.
• Careful preoperative assessment and management are crucial for patients with coexisting kidney stones undergoing nephrectomy.