Laparoscopic transperitoneal and retroperitoneal simple nephrectomy: The impact of etiological factors of the results of surgical treatment

Abstract

Objective: This retrospective study compares the perioperative outcomes of laparoscopic simple nephrectomy (LSN) in patients with urinary stone disease (USD) in comparison with LSNs performed for other etiological factors.

Material and methods: 115 LSNs were identified from the two teaching hospitals' database. Depending on the etiological factors, patients were stratified in 2 groups. Group 1 consisted of 63 (mean age 44.8±1.7 [21-71] years) patients; where the cause of non-functioning kidney was USD. Meanwhile, Group 2 included 52 (mean age was 43.6±2.0 [19-78] years) patients; who underwent LSN because of other benign diseases. In both groups, a standardized transabdominal or retroperitoneal approach was used according to the discretion of the attending surgeon. Two groups were compared statistically in terms of perioperative parameters and standardized surgical complications.

Results: The use of transperitoneal approach was higher in Group 1 (69.8% vs. 30.2%) compared to Group 2 (51.9% vs. 48.1%). Elective open conversion was needed in 3 and 2 patients in Groups 1 and 2, respectively. The results for mean operative time (108.9±4.0 min vs. 106.7±5.0), estimated blood loss (92.5±8.2 vs. 86.8±10.1 mL) and length of hospital stay (4.1±0.33 vs. 3.85±0.42 days) were similar between the groups. Despite intraoperative complications were similar between the groups, overall post-operative complications were significantly higher (17.5% vs. 3.8%) in Group 1. However, the rate of significant complications (Clavien 3-5) was similar between the groups.

Conclusion: The present study revealed that perioperative outcomes of patients undergoing LSN for USD are similar to those seen in patients undergoing LSN for other etiological factors.

Keywords: Complication; laparoscopy; nephrectomy; transperitoneal.