TY - JOUR
T1 - Laparoscopic nephrectomy for infected, obstructed and non-functioning kidneys
AU - Katz, Ran
AU - Pode, Dov
AU - Golijanin, Dragan
AU - Gofrit, Ofer N.
AU - Shenfeld, Ofer Z.
AU - Shapiro, Amos
AU - Reissman, Petachia
PY - 2004/12
Y1 - 2004/12
N2 - Since laparoscopic nephrectomy was introduced by dayman et al,1 it has been doubted whether it should be employed in patients with extensive perirenal fibrosis. In this series, 20 consecutive patients underwent laparoscopic nephrectomy for obstructed, infected, non-functioning kidneys. Preoperative assessment included urine cultures, abdominal sonography, intravenous pyelography, computerized tomography and a renal scan. Laparoscopic nephretomies were performed using either the transperitoneal or the retroperitoneal approach. Patients' mean age was 52 years (range 20-77, SD = 15.2). Three patients underwent previous open surgery on the same kidney and 15 had percutaneous nephrostomies. The etiology of obstruction was stone disease in 15 cases, uretero-pelvic junction obstruction (3), iatrogenic ureteral injury (1), and infected multicystic kidney (1). Mean operative time was 224 minutes (range 140-325, SD = 57). Conversion to open surgery was necessary in one patient due to splenic injury. Mean hospital stay was 3 days (range 2-6, SD = 1). Laparoscopic nephrectomy was feasible in cases of severe perirenal fibrosis, with an acceptable rate of complications, and may be considered in patients with obstructed, infected, and non-functioning kidneys.
AB - Since laparoscopic nephrectomy was introduced by dayman et al,1 it has been doubted whether it should be employed in patients with extensive perirenal fibrosis. In this series, 20 consecutive patients underwent laparoscopic nephrectomy for obstructed, infected, non-functioning kidneys. Preoperative assessment included urine cultures, abdominal sonography, intravenous pyelography, computerized tomography and a renal scan. Laparoscopic nephretomies were performed using either the transperitoneal or the retroperitoneal approach. Patients' mean age was 52 years (range 20-77, SD = 15.2). Three patients underwent previous open surgery on the same kidney and 15 had percutaneous nephrostomies. The etiology of obstruction was stone disease in 15 cases, uretero-pelvic junction obstruction (3), iatrogenic ureteral injury (1), and infected multicystic kidney (1). Mean operative time was 224 minutes (range 140-325, SD = 57). Conversion to open surgery was necessary in one patient due to splenic injury. Mean hospital stay was 3 days (range 2-6, SD = 1). Laparoscopic nephrectomy was feasible in cases of severe perirenal fibrosis, with an acceptable rate of complications, and may be considered in patients with obstructed, infected, and non-functioning kidneys.
KW - Adhesions
KW - Fibrosis
KW - Laparoscopy
KW - Non-functioning kidneys
UR - http://www.scopus.com/inward/record.url?scp=11144237211&partnerID=8YFLogxK
U2 - 10.1097/01.sle.0000148466.25814.e1
DO - 10.1097/01.sle.0000148466.25814.e1
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C2 - 15599298
AN - SCOPUS:11144237211
SN - 1530-4515
VL - 14
SP - 340
EP - 343
JO - Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
JF - Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
IS - 6
ER -