Complications of laparoscopic nephrectomy in 185 patients: a multi-institutional review.
OBJECTIVE
We document the incidence of complications associated with laparoscopic nephrectomy in a multi-institutional study.


METHODS
The study included the initial 185 patients undergoing laparoscopic nephrectomy at 5 centers in the United States between June 1990 and July 1993.


RESULTS
A total of 30 patients (16%) had 34 complications. There was no mortality. Access-related complications included 2 cases of hernia formation at the trocar site, 1 abdominal wall hematoma and 1 trocar injury to a hydronephrotic kidney. Intraoperative complications included 5 cases of vascular injury, 1 splenic laceration and 1 pneumothorax. Postoperative complications involved the gastrointestinal tract in 6 cases, cardiovascular system in 6, genitourinary tract in 4, respiratory system in 4 and musculoskeletal system in 2. Miscellaneous complications occurred in 3 patients. Open surgical intervention was required electively in 8 patients and on an emergency basis in 2. The incidence of complications decreased with experience: 71% occurred during the initial 20 cases at each institution.


CONCLUSIONS
In our early experience the complication rate for laparoscopic nephrectomy was 12% in patients with benign renal disease and 34% in those with renal cancer. Based on this collective experience, recommendations for prevention, recognition and treatment of complications are made.
Gill
I S
IS
Division of Urology, University of Kentucky, Albert Chandler Medical Center, Lexington, USA.
Kavoussi
L R
LR
Clayman
R V
RV
Ehrlich
R
R
Evans
R
R
Fuchs
G
G
Gersham
A
A
Hulbert
J C
JC
McDougall
E M
EM
Rosenthal
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology; D007674:Kidney Diseases / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects*; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology