title: The efficacy and safety of laparoscopic nephrectomy in patients with three or more comorbidities.
abstract: OBJECTIVE
  Laparoscopic surgery for kidney treatment is a common procedure. However, the efficacy of this procedure in patients with several comorbidities has not been well investigated. We conducted a retrospective comparison of results of laparoscopic surgery between patients with several comorbidities and patients with no comorbidity to access the efficacy and safety of this procedure.
  
  
  METHODS
  The subjects were 20 patients with three or more comorbidities (group A) and 46 patients with less than three comorbidities (group B). These 66 patients were 48 men and 18 women with a mean age of 62.3 years (age range, 24-83 years). The data from these two groups were compared for American Society of Anesthesiology (ASA) physical status score, previous surgical history, duration of surgery, estimated blood loss, tumor size, complications during and after surgery, conversion rates, time to oral intake, and length of hospital stay.
  
  
  RESULTS
  The initial ASA score and age were significantly higher for the patients with comorbidities (P < 0.0001, P = 0.0008, respectively). All other variables before, during, and after surgery were similar for both laparoscopic groups. However, the incidence of atelectasis of laparoscopy was higher than that of open surgery.
  
  
  CONCLUSIONS
  Laparoscopic nephrectomy for patients with comorbidities is safe and minimally invasive. Further investigation to prevent atelectasis is necessary.
authors.affiliation: Department of Urology, Graduate School of Medicine, Research Center for Frontier Medical Engineering, Chiba University, Chiba, Japan. yu7ki@aol.com
authors.forename: Yukio
authors.initials: Y
authors.lastname: Naya
authors.forename: Toyofusa
authors.initials: T
authors.lastname: Tobe
authors.forename: Takahito
authors.initials: T
authors.lastname: Suyama
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Araki
authors.forename: Akira
authors.initials: A
authors.lastname: Komiya
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Suzuki
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Igarashi
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Ichikawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications* / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies