title: Prospective randomized comparison of transperitoneal vs retroperitoneal laparoscopic simple nephrectomy.
abstract: OBJECTIVE
  To compare the results of transperitoneal laparoscopic vs retroperitoneoscopic simple nephrectomy for benign renal diseases in a prospective randomized design.
  
  
  METHODS
  In this study between January 2009 and August 2013, 31 patients underwent transperitoneal laparoscopic nephrectomy and 31 retroperitoneoscopic nephrectomy after randomization. The 2 groups were compared for the visual pain score on the first and second postoperative days as the primary end point of the study. Complications were recorded and graded using Dindo-modified Clavien classification of surgical complications. Secondary objectives were to compare each of the operative techniques in terms of duration of surgery, complication rates, and postoperative convalescence. Statistical analysis was performed with SPSS version 16.0 with P <.05 considered statistically significant.
  
  
  RESULTS
  The difference in the visual pain score (4.9 vs 2.7 on day 1; 3.2 vs 1.1 on day 2) and the tramadol requirements (167.3 vs 132.8 mg) were statistically significant and more in the transperitoneal laparoscopic nephrectomy. The hospital stay and convalescence were significantly lower in retroperitoneoscopic group. Three patients in transperitoneal laparoscopic nephrectomy group and 2 patients in retroperitoneoscopic group required conversion. Mean time to normal activities was significantly less in retroperitoneal laparoscopic nephrectomy group (16.7 ± 3.5 vs 9.34 ± 4.9 days; P = .0001).
  
  
  CONCLUSIONS
  Although both transperitoneal laparoscopic and retroperitoneoscopic simple nephrectomy are feasible options for nonfunctioning kidneys due to benign renal diseases in adults, retroperitoneal laparoscopic nephrectomy is associated with significantly less pain, less analgesic requirement, shorter hospital stay, and short convalescence as compared with transperitoneal laparoscopic approach.
authors: Department of Urology, King George Medical University (also, Chhatrapati Shahuji Maharaj Medical University), Lucknow, India. Electronic address: dr_manugarg@yahoo.co.in.
authors: Manish
authors: M
authors: Garg
authors: Department of Urology, King George Medical University (also, Chhatrapati Shahuji Maharaj Medical University), Lucknow, India.
authors: Vishwajeet
authors: V
authors: Singh
authors: Department of Urology, King George Medical University (also, Chhatrapati Shahuji Maharaj Medical University), Lucknow, India.
authors: Rahul Janak
authors: RJ
authors: Sinha
authors: Department of Urology, King George Medical University (also, Chhatrapati Shahuji Maharaj Medical University), Lucknow, India.
authors: Pradeep
authors: P
authors: Sharma
mesh_terms: D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D010537:Peritoneum; D011446:Prospective Studies; D012187:Retroperitoneal Space