Laparoscopic Nephrectomy: Experience with 23 Cases

Kang, Il Mo; Lee, Kyu Sung

Abstract

PURPOSE: Laparoscopic nephrectomy has become accepted as a method of simple nephrectomy replacing with open nephrectomy in patients in whom a kidney requires removal for benign disease. Laparoscopic nephrecto my is widely performed and extends its indications. We evaluated our experience with the laparoscopic nephrectomy to assess the clinical efficacy.
MATERIALS AND METHODS
Between April 1996 and September 1999, 23 patients (7 men and 16 women, mean age 44.1 years old) underwent laparoscopic nephrectomy, 16 by women, mean age 44.1 years old) underwent laparoscopic nephrectomy, 16 by the transperitoneal approach and 7 by the retroperitoneal approach. Operative and clinical records were reviewed. The underlying pathological conditions included 20 cases of non-functioning kidney, 2 cases of hypoplastic kidney with complete duplication and ectopic ureter, and 1 case of ureter tumor. Four ports (21 cases, two 12mm ports and two 5mm ports) or 5 posts ( 2 cases, two 12mm ports and three 5mm ports) were used.
RESULTS
The laparoscopic procedure were successful in 20 cases (87%). Three patients had open conversion due to unclear anatomy, severe adhesion, and adrenal bleeding. In successful cases, mean operative time was 253+/-83 minutes (range 140-545), mean hospital stay was postoperative 5.2 days. Intraoperative and perioperative complications were noted in 6 patients, including bleeding requiring transfusion in 3, wound infection in 1, severe subcutaneous emphysema in 1, diarrhea in 1.
CONCLUSIONS
Laparoscopic simple nephrectomy is feasible, effective, and safe treatment option. It is a less invasive alternative to open surgery providing a more rapid recuperation and superior cosmetic effect.