Nephrectomies in Saudi Arabia: A Comprehensive Analysis of Outcomes from a High-Volume Minimally Invasive Surgery...

Area of Science:

• Urology
• Surgical Oncology
• Medical Outcomes Research

Background:

• Limited literature exists on nephrectomy outcomes in Saudi Arabia.
• Surgical techniques for nephrectomy include open, laparoscopic, and robotic approaches.
• Comparing outcomes of different nephrectomy procedures is crucial for patient care.

Purpose of the Study:

• To compare surgical and oncological outcomes between open and minimally invasive nephrectomies.
• To evaluate the effectiveness of different nephrectomy types (simple/total, radical, partial, nephroureterectomy).
• To provide data on nephrectomy outcomes in the Saudi Arabian context.

Main Methods:

• Retrospective cohort study of 408 adult cancer patients undergoing nephrectomy from January 2015 to January 2023.
• Data collected included demographics, intraoperative, and postoperative variables.
• Statistical analysis used Kaplan-Meier curves, log-rank tests, and comparison of means/proportions (P<0.05 significant).

Main Results:

• Minimally invasive surgery showed significantly lower blood loss, transfusion rates, hospital stay, and complications compared to open nephrectomy.
• Oncological outcomes like local recurrence, metastatic progression, and chemotherapy use were also lower with minimally invasive approaches.
• While survival differences between open and minimally invasive procedures were not significant, survival varied significantly among different nephrectomy types (simple/total, RN, PN, nephroureterectomy).

Conclusions:

• Minimally invasive nephrectomies are associated with reduced inpatient morbidity compared to open procedures.
• Both surgical and oncological outcomes are comparable between open and minimally invasive nephrectomies.
• Different nephrectomy types yield statistically significant differences in survival outcomes.