Comparison of Retroperitoneoscopic Simple Nephrectomy with Open Simple Nephrectomy

Kim, Geun Soo; Kwon, Dong Deuk; Oh, Bong Ryoul; Ryu, Soo Bang; Park, Yang Il

Abstract

We evaluated our experience of retroperitoneoscopic simple nephrectomy, and compared its results with those of open nephrectomy performed at our institution. Since Jan 2001, 15 patients underwent retroperitoneoscopic nephrectomies and 20 received open nephrectomy at our institution. The differences of outcomes between the two groups were analyzed by the Mann-Whitney test. Results: The mean operative time was 228+/-77 minutes for the retroperitoneoscopic group, which was longer than the 150+/-53 mintues for open group (p<0.005). The mean estimated blood loss was 133+/-145ml for the retroperitoneoscopic group, significantly less than that for open nephrectomy group with 390+/-161ml. Postoperative analgesics requirements in retroperitoneoscopic group were also less than open group. Mean hospital stay, time to ambulation and oral intake were 4.87+/-1.4 days, 24.3+/-6.0 hours and 25.6+/-9.1 hours for retroperitoneoscopic groups, which were significantly shorter than those for open nephrectomy, 8.5+/-1.5 days, 40.4+/-13.9 hours and 46.6+/-9.0 hours, respectively. However, mean hospital cost was 2,162+/-292 thousand won for retroperitoneoscopic group, more expensive than 1,507+/-376 thousand won for open nephrectomy. Retropetitoneoscopic approach appears to be as feasible, effective, and safe as open surgery in the treatment of simple nephrectomy. It is a less invasive alternative to open nephrectomy, providing a more rapid rehabilitation and superior cosmetic effect. More extensive experience and longer follow-up would be necessary to confirm these results.