Retroperitoneoscopic subcapsular nephrectomy for infective nonfunctioning kidney with dense perinephric adhesions.
OBJECTIVE
To evaluate the feasibility and clinical efficacy of retroperitoneoscopic subcapsular nephrectomy for infective nonfunctioning kidneys with dense perinephric adhesions.


METHODS
Twelve patients underwent retroperitoneoscopic subcapsular nephrectomy; the operative duration, blood loss, intestinal functional recovery time, complications during surgery and efficacy were recorded. Dissociation and ligation of the renal pedicle was the most important step, at which the renal capsule was cut near the renal hilum using a harmonic scalpel, and the fatty tissue around the renal hilum dissected carefully. The renal pedicle was then ligated and divided using an endoscopic linear stapler-cutter after the renal pedicle tissues had been separated to an adequate thickness.


RESULTS
All 12 operations were successful and none required conversion to open surgery. The mean (SD, range) operative duration was 82.9 (22.3, 45-120) min, the blood loss 51.4 (12.2, 30-75) mL and the intestinal functional recovery time 12-48 h. There were no complications during or after the surgery, and in the follow-up of 1-15 months the short-term results were satisfactory.


CONCLUSIONS
Retroperitoneoscopic subcapsular nephrectomy can be used safely to remove an infected and heavily adhesive nonfunctioning kidney, with minimal trauma and blood loss, and with faster recovery than after an open subcapsular nephrectomy.
Xu
Zhang
Z
Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China. xzhang@tjh.tjmu.edu.cn
Xin
Ma
M
Hong-Zhao
Li
L
Zhong
Chen
C
Li
Long-Cheng
LC
Ye
Zhang-Qun
ZQ
D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011704:Pyelonephritis / Q000473:pathology / Q000601:surgery*; D000267:Tissue Adhesions / Q000209:etiology / Q000601:surgery; D014398:Tuberculosis, Renal / Q000473:pathology / Q000601:surgery*