title: Nephrectomy: A comparative study between the transperitoneal and retroperitoneal laparoscopic versus the open approach.
abstract: OBJECTIVE
  Different techniques have been introduced to perform laparoscopic nephrectomy using either the transperitoneal or the retroperitoneal route. However, to date only few data exist comparing the results and morbidity of these procedures as well as with the standard technique of open nephrectomy.
  
  
  METHODS
  This paper compares the clinical results of 18 transperitoneal laparoscopic nephrectomies (TLN) for benign renal disease with 17 retroperitoneal laparoscopic nephrectomies (RLN) and 19 consecutive open nephrectomies (Nx). All groups were comparable in terms of indication. The analysis of clinical data included operative time, morbidity, length of analgesic use and postoperative hospital stay.
  
  
  RESULTS
  The mean operative time for benign disease was 206.5 for TLN, 211.2 for RLN and 117 min for open nephrectomy. Analgesic medication requirement per patient was 2 days for TLN, 1 day for RLN and 4 days for Nx while the postoperative hospital stay averaged 7 days for TLN, 6 days for RLN and 10 days for Nx. The time of convalescence was 21 days after RLN, 24 days after TLN versus 40 days after open nephrectomy.
  
  
  CONCLUSIONS
  Our results demonstrate an overall clear advantage of a laparoscopic approach when compared to open surgery and also reveals distinct benefits of a retroperitoneal approach.
authors.affiliation: Department of Urology, Stadtkrankenhaus Heilbronn, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Rassweiler
authors.forename: T
authors.initials: T
authors.lastname: Frede
authors.forename: T O
authors.initials: TO
authors.lastname: Henkel
authors.forename: C
authors.initials: C
authors.lastname: Stock
authors.forename: P
authors.initials: P
authors.lastname: Alken
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000008:administration & dosage; D002648:Child; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D010537:Peritoneum; D011379:Prognosis; D012187:Retroperitoneal Space; D016896:Treatment Outcome
chemical_list: D000700:Analgesics