Perioperative Complications in Patients Undergoing Simultaneous Bilateral Lumboscopic Nephrectomy

Area of Science:

• Nephrology
• Surgical Innovation
• Transplant Surgery

Background:

• Bilateral nephrectomy is crucial for optimizing kidney transplant recipients.
• Simultaneous bilateral lumboscopic nephrectomy is a minimally invasive technique with limited documentation.
• This procedure is considered for patients with end-stage renal disease in transplant protocols.

Purpose of the Study:

• To evaluate the frequency and characteristics of major postoperative complications (Clavien-Dindo grade ≥3) after simultaneous bilateral lumboscopic nephrectomy.
• To assess the safety and feasibility of this surgical approach in renal transplant candidates.

Main Methods:

• Retrospective cohort study of 17 patients undergoing simultaneous bilateral lumboscopic nephrectomy, nephroureterectomy, and bladder cuff excision (January 2015 - February 2024).
• Analysis of clinical and surgical variables, including operative time, blood loss, and transfusion requirements.
• Complications were graded using the Clavien-Dindo classification.

Main Results:

• The study included 17 patients (mean age 42.2 years, 64.7% female) with end-stage renal disease.
• The primary indication was recurrent urinary tract infections due to vesicoureteral reflux (64.7%).
• Two grade III, two grade II, and three grade I complications occurred; no vascular or visceral complications were reported. Six patients proceeded to renal transplantation.

Conclusions:

• Simultaneous bilateral lumboscopic nephrectomy with nephroureterectomy and bladder cuff excision is safe and feasible for kidney transplant candidates.
• The technique demonstrates an acceptable rate of major complications.
• It effectively preserves the patient's previous dialysis modality.