title: Transperitoneal laparoscopic nephrectomy for autosomal dominant polycystic kidney disease.
abstract: OBJECTIVE
  This study focuses on laparoscopic nephrectomy for autosomal dominant polycystic kidney disease (ADPKD).
  
  
  METHODS
  We retrospectively reviewed 21 consecutive patients who had previously undergone laparoscopy between 2007 and 2010. Data were compared  to that obtained from 19 consecutive patients who had open surgery between 2004 and 2007. Clinical parameters, operative data, perioperative mortality, postoperative complications, and length of hospital stay were compared using χ(2) and Student ttests for qualitative and  quantitative variables, respectively.
  
  
  RESULTS
  Nephrectomy is usually performed to create space for renal transplantation (81% and 79%, respectively). Operating time was longer with the laparoscopic approach (180 min vs. 128 min, P = .001). Blood loss was comparable in the  2 groups (154 vs. 222 ml, P = .359) but 3 patients were transfused in the open surgery group as compared with 1 patient in the laparoscopic group. No conversion was needed. There was a trend in the laparoscopic group with respect to lower consumption of analgesics in the postoperative  period (P = .06). Delay to transit recovery (2.1 d vs 4.1 d, P < .001) and hospital stay (5.2 d vs. 8.28 d, P = .002) were significantly decreased in the laparoscopic group. The interval from surgery to renal transplantation was lower in patients operated on laparoscopically  (3.1 vs. 12 mo). Complications occurred in 33% of the patients in the laparoscopic group as compared with 68% in the open surgery group (P = .22). Severe complications were less frequent in the laparoscopic group (9.5% vs. 37%, P = .04).
  
  
  CONCLUSIONS
  Laparoscopic nephrectomy  is a feasible and safe procedure for ADPKD. Morbidity is significantly reduced compared with the open approach.
authors: Department of Urology, Rennes University Hospital, Cedex, France. gregory.verhoest@chu_rennes.fr
authors: Grégory
authors: G
authors: Verhoest
authors: Arnaud
authors: A
authors: Delreux
authors: Romain
authors: R
authors: Mathieu
authors: Jean-Jacques
authors: JJ
authors: Patard
authors: Cécile
authors: C
authors: Vigneau
authors: Nathalie
authors: N
authors: Rioux-Leclercq
authors: Karim
authors: K
authors: Bensalah
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D010537:Peritoneum / Q000601:surgery*; D016891:Polycystic Kidney, Autosomal Dominant / Q000601:surgery*; D011184:Postoperative Period; D051437:Renal Insufficiency / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome