Complications and the learning curve for a laparoscopic nephrectomy at a single institution.
BACKGROUND
We assessed our experiences in performing a laparoscopic nephrectomy, with regard to complications and the learning curve, during a 4-year period.


METHODS
Between November 2000 and October 2004, a total of 78 laparoscopic nephrectomies were performed at our institution (37 radical nephrectomies, 30 nephroureterectomies and 11 simple nephrectomies). The patient charts were retrospectively reviewed to identify any operative and postoperative complications, and also to evaluate the operating time.


RESULTS
A total of eleven complications (14.1%) occurred in our series (nine operative and two postoperative complications). All operative complications were due to vascular injuries (n=9), five (2.6%) of which required an open conversion. The operating time and the rates of complications decreased significantly as the surgeons' experiences increased.


CONCLUSIONS
A laparoscopic nephrectomy could be performed as safely as previously reported. In addition, the learning curve for a laparoscopic nephrectomy appeared to be good over the initial 50 procedures at our institution.
Kanno
Toru
T
Department of Urology, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, Osaka, Japan. t-kanno@kitano-hp.or.jp
Shichiri
Yasumasa
Y
Oida
Tomoyuki
T
Kanamaru
Hiroshi
H
Takao
Noriyasu
N
Shimizu
Yosuke
Y
D006801:Humans; D007674:Kidney Diseases / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects*; D009392:Nephrectomy / Q000009:adverse effects* / Q000193:education* / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies