Should retroperitoneoscopic nephrectomy be the standard of care for benign nonfunctioning kidneys? An outcome analysis based on experience with 449 cases in a 5-year period.
OBJECTIVE
Laparoscopic nephrectomy has become a routine procedure at specialized centers with the advantages of less postoperative pain, minimal scars, rapid recovery and short convalescence. We report our experience with the establishment of retroperitoneoscopic nephrectomy as the standard of care for benign nonfunctioning kidneys.


METHODS
We retrospectively compared the records of patients who underwent simple nephrectomy retroperitoneoscopically or by open surgery from January 1998 to October 2003 at our center.


RESULTS
A total of 351 simple nephrectomies were done retroperitoneoscopically, while 83 were done as an open procedure. Mean operative time was significantly longer in the retroperitoneoscopic group. However, mean blood loss, complication rate, hospital stay and convalescence were significantly less in the retroperitoneoscopic group.


CONCLUSIONS
Retroperitoneoscopic nephrectomy has become a standardized procedure. It should be offered as the primary treatment modality to patients with benign renal disease scheduled for elective nephrectomy except in those in whom it is contraindicated.
Gupta
Narmada P
NP
Department of Urology, All India Institute of Medical Sciences, New Delhi, India. narmadagupta@hotmail.com
Goel
Rajiv
R
Hemal
Ashok K
AK
Dogra
P N
PN
Seth
Amlesh
A
Aron
Monish
M
Kumar
Rajeev
R
Ansari
M S
MS
D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D003289:Convalescence; D019091:Critical Pathways / Q000592:standards; D006801:Humans; D007194:India; D007674:Kidney Diseases / Q000601:surgery*; D010535:Laparoscopy / Q000592:standards*; D007902:Length of Stay / Q000706:statistics & numerical data; D009392:Nephrectomy / Q000592:standards*; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies