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. 2023 Jan 5;408(1):8.
doi: 10.1007/s00423-022-02737-9.

Introduction of laparoscopic nephrectomy for autosomal dominant polycystic kidney disease as the standard procedure

M N Thomas  1 , R R Datta  2 , R Wahba  2 , D Buchner  2 , C Chiapponi  2 , C Kurschat  3 , F Grundmann  3 , A Urbanski  2 , S Tolksdorf  2 , R Müller  3 , J Henze  4 , V-M Petrescu-Jipa  5 , F Meyer  4 , C J Bruns  2 , D L Stippel  2
Affiliations

Introduction of laparoscopic nephrectomy for autosomal dominant polycystic kidney disease as the standard procedure

M N Thomas et al. Langenbecks Arch Surg. .

Erratum in

Abstract

Purpose: Autosomal dominant polycystic kidney disease (ADPKD) is a common hereditary disorder and accounts for 5-10% of all cases of kidney failure. 50% of ADPKD patients reach kidney failure by the age of 58 years requiring dialysis or transplantation. Nephrectomy is performed in up to 20% of patients due to compressive symptoms, renal-related complications or in preparation for kidney transplantation. However, due to the large kidney size in ADPKD, nephrectomy can come with a considerable burden. Here we evaluate our institution's experience of laparoscopic nephrectomy (LN) as an alternative to open nephrectomy (ON) for ADPKD patients.

Materials and methods: We report the results of the first 12 consecutive LN for ADPKD from August 2020 to August 2021 in our institution. These results were compared with the 12 most recent performed ON for ADPKD at the same institution (09/2017 to 07/2020). Intra- and postoperative parameters were collected and analyzed. Health related quality of life (HRQoL) was assessed using the SF36 questionnaire.

Results: Age, sex, and median preoperative kidney volumes were not significantly different between the two analyzed groups. Intraoperative estimated blood loss was significantly less in the laparoscopic group (33 ml (0-200 ml)) in comparison to the open group (186 ml (0-800 ml)) and postoperative need for blood transfusion was significantly reduced in the laparoscopic group (p = 0.0462). Operative time was significantly longer if LN was performed (158 min (85-227 min)) compared to the open procedure (107 min (56-174 min)) (p = 0.0079). In both groups one postoperative complication Clavien Dindo ≥ 3 occurred with the need of revision surgery. SF36 HRQol questionnaire revealed excellent postoperative quality of life after LN.

Conclusion: LN in ADPKD patients is a safe and effective operative procedure independent of kidney size with excellent postoperative outcomes and benefits of minimally invasive surgery. Compared with the open procedure patients profit from significantly less need for transfusion with comparable postoperative complication rates. However significant longer operation times need to be taken in account.

Keywords: ADPKD; Kidney transplantation; Laparoscopic nephrectomy.

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Conflict of interest statement

The authors declare no competing interests.

Drs. Michael N. Thomas, Rabi. R.Datta, Roger Wahba, Denise Buchner, Costanza Chiapponi, Christine Kurschat, Franziska Grundmann, Alexander Urbanski, Svenja Tolksdorf, Roman Müller, Jörn Henze, Viorica Petrescu, Franziska Meyer, Christiane J. Bruns, and Dirk L. Stippel have no conflicts of interest or financial ties to disclose.

Figures

Fig. 1
Fig. 1
a Preoperative CT scan after kidney transplantation and before staged bilateral cystnephrectomy. b Port placement for right sided LN
Fig. 2
Fig. 2
Postoperative situs after laparoscopic right sided nephrectomy
Fig. 3
Fig. 3
Serum creatinine values pre- and post-cystnephrectomy
Fig. 4
Fig. 4
Intraoperative specimen volume reduction of laparoscopic performed cystnephrectomies
Fig. 5
Fig. 5
Postoperative hospital stay
Fig. 6
Fig. 6
Postoperative HrQoL according to SF-36 questionnaire
See this image and copyright information in PMC

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