TY - JOUR
T1 - Laparoscopic nephrectomy for nonfunctioning kidneys is feasible after previous ipsilateral renal surgery
T2 - A prospective cohort trial
AU - Aminsharifi, Alireza
AU - Taddayun, Alireza
AU - Niroomand, Reza
AU - Hosseini, Mohammad Mehdi
AU - Afsar, Firoozeh
AU - Afrasiabi, Mohammad Amin
N1 - Funding Information:
Supported by Shiraz University of Medical Sciences .
PY - 2011/3
Y1 - 2011/3
N2 - Purpose Previous renal surgery is a relative contraindication to laparoscopic nephrectomy because adhesion formation makes surgical dissection difficult. We determined whether previous surgery at the same anatomical site would affected the surgical outcome in patients who underwent transperitoneal laparoscopic nephrectomy. Materials and Methods During the study period 79 consecutive patients who underwent transperitoneal laparoscopic nephrectomy were evaluated prospectively. All patients had symptomatic nonfunctioning small or hydronephrotic kidneys. Patients were divided into 29 with and 50 without prior surgery at the same anatomical site. Previous surgery included open nephrolithotomy in 16 patients, percutaneous nephrolithotomy in 8, open and percutaneous nephrolithotomy in 3, pyelolithotomy in 1 and pyeloplasty in 1. Results Patients who underwent prior surgery were older than patients who did not (average age 46.6 vs 34.9 years, p = 0.008). Other patient characteristics, including gender ratio, body mass index and side of surgery, did not differ significantly between the 2 groups. Mean operative time was longer in patients with previous surgery than in the other group (98.6 vs 62.3 minutes, p = 0.03). Other operative data, including blood loss, intraoperative and postoperative complications, open conversion and hospital stay, were similar in the groups. One case per group was converted to open surgery due to difficult pedicle dissection. Conclusions Transperitoneal laparoscopic nephrectomy in patients with a history of ipsilateral renal surgery can be done safely in timely fashion. Although mean operative time was longer, there was no significant increase in the operative complication rate in patients with prior surgery.
AB - Purpose Previous renal surgery is a relative contraindication to laparoscopic nephrectomy because adhesion formation makes surgical dissection difficult. We determined whether previous surgery at the same anatomical site would affected the surgical outcome in patients who underwent transperitoneal laparoscopic nephrectomy. Materials and Methods During the study period 79 consecutive patients who underwent transperitoneal laparoscopic nephrectomy were evaluated prospectively. All patients had symptomatic nonfunctioning small or hydronephrotic kidneys. Patients were divided into 29 with and 50 without prior surgery at the same anatomical site. Previous surgery included open nephrolithotomy in 16 patients, percutaneous nephrolithotomy in 8, open and percutaneous nephrolithotomy in 3, pyelolithotomy in 1 and pyeloplasty in 1. Results Patients who underwent prior surgery were older than patients who did not (average age 46.6 vs 34.9 years, p = 0.008). Other patient characteristics, including gender ratio, body mass index and side of surgery, did not differ significantly between the 2 groups. Mean operative time was longer in patients with previous surgery than in the other group (98.6 vs 62.3 minutes, p = 0.03). Other operative data, including blood loss, intraoperative and postoperative complications, open conversion and hospital stay, were similar in the groups. One case per group was converted to open surgery due to difficult pedicle dissection. Conclusions Transperitoneal laparoscopic nephrectomy in patients with a history of ipsilateral renal surgery can be done safely in timely fashion. Although mean operative time was longer, there was no significant increase in the operative complication rate in patients with prior surgery.
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U2 - 10.1016/j.juro.2010.10.075
DO - 10.1016/j.juro.2010.10.075
M3 - Article
C2 - 21251677
AN - SCOPUS:79951554112
SN - 0022-5347
VL - 185
SP - 930
EP - 934
JO - Journal of Urology
JF - Journal of Urology
IS - 3
ER -