Laparoscopic nephrectomy for infected, obstructed and non-functioning kidneys

Ran Katz, Dov Pode, Dragan Golijanin, Ofer N. Gofrit, Ofer Z. Shenfeld, Amos Shapiro, Petachia Reissman

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)340-343
Number of pages4
JournalSurgical Laparoscopy, Endoscopy and Percutaneous Techniques
Volume14
Issue number6
DOIs
StatePublished - Dec 2004
Externally publishedYes

Keywords

  • Adhesions
  • Fibrosis
  • Laparoscopy
  • Non-functioning kidneys

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