title: 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.
abstract: 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.
authors.affiliation: Department of Urology, All India Institute of Medical Sciences, New Delhi, India. narmadagupta@hotmail.com
authors.forename: Narmada P
authors.initials: NP
authors.lastname: Gupta
authors.forename: Rajiv
authors.initials: R
authors.lastname: Goel
authors.forename: Ashok K
authors.initials: AK
authors.lastname: Hemal
authors.forename: P N
authors.initials: PN
authors.lastname: Dogra
authors.forename: Amlesh
authors.initials: A
authors.lastname: Seth
authors.forename: Monish
authors.initials: M
authors.lastname: Aron
authors.forename: Rajeev
authors.initials: R
authors.lastname: Kumar
authors.forename: M S
authors.initials: MS
authors.lastname: Ansari
mesh_terms: 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