title: Laparoscopic simple nephrectomy: perioperative outcomes at Srinagarind Hospital.
abstract: BACKGROUND
  Laparoscopic urology is a minimally invasive alternative to open surgery, especially laparoscopic simple nephrectomy for benign disease such as KUB stone.
  
  
  OBJECTIVE
  To evaluate the efficacy and perioperative outcomes of laparoscopic simple nephrectomy at Srinagarind Hospital.
  
  
  METHODS
  Analyzed the demographic and perioperative data of 78 consecutive patients who underwent laparoscopic simple nephrectomy.
  
  
  RESULTS
  Mean age was 54.1. The indications included non-functioning kidney (64) and infection (14). Surgery averaged 118.37 minutes. In 38 and 40 respective cases, a transperitoneal and retroperitoneal approach was used. Intraoperative complications (13; 16.7%) included 10 bleeding, 2 diaphragmatic injuries and 1 pancreatic injury. Six cases (10.3%) were converted to open surgery: 5 for massive adhesion and 1 for uncontrolled bleeding. Mean estimated blood loss was 170.99 ml. Post-operative complications included: 8 cases of prolonged ileus and 5 wound infections. Mean post-operative analgesia was 14.0 mg morphine: mean pain score at post-operative day 1 6.20. Mean time to oral intake was 1.48 days, and post-operative period 4.63 days. Retroperitoneal access was associated with: shorter operative time (103.83 vs. 133.68 minutes, p = 0.008); a better result vis-a-vis post-operative ileus (1 vs. 7, p = 0.021); and shorter time to oral intake than transperitoneal route (1.20 vs. 1.79 days, p = 0.004).
  
  
  CONCLUSIONS
  Vis-a-vis reducing pain, faster recovery and improved cosmetics laparoscopic nephrectomy by a skilled surgeon via retroperitoneal approach is preferred for benign diseases.
authors: Department of Surgery, Khon Kaen University, Khon Kaen, Thailand. wichien125@hotmail.com
authors: Kengkart
authors: K
authors: Winaikosol
authors: Kachit
authors: K
authors: Phacherat
authors: Ekkarin
authors: E
authors: Chotikawanich
mesh_terms: D005260:Female; D006761:Hospitals; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012189:Retrospective Studies; D013785:Thailand; D016896:Treatment Outcome