Abstract
Purpose To present our surgical techniques and experiences of retroperitoneal laparoscopic nephroureterectomy for the treatment of tuberculous nonfunctioning kidneys.Materials and Methods From March 2005 to March 2013, a total of 51 patients with tuberculous nonfunctioning kidney underwent retroperitoneal laparoscopic nephroureterectomy at our medical center. The techniques included early control of renal vessels and dissection of the diseased kidney along the underlying layer outside the Gerato’s fascia. The distal ureter was dissected through a Gibson incision and the entire specimen was removed en bloc from the incision. Patient demographics, perioperative characteristics and laboratory parameters as well as postoperative outcome were retrospectively reviewed.Results Retroperitoneal laparoscopic nephroureterectomy was successfully performed in 50 patients, whereas one case required conversion to open surgery due to non-progression of dissection. The mean operating time was 123.0 minutes (107-160 minutes) and the mean estimated blood loss was 134 mL (80-650 mL).The mean postoperative hospital stay was 3.6 days (3-5days) and the mean return to normal activity was 11.6 days (10-14days). Most intra-operative and post-operative complications were minor complications and can be managed conservatively. After 68 months (12-96 months) follow-up, the outcome was satisfactory, and ureteral stump syndrome did not occur.Conclusions Retroperitoneal laparoscopic nephroureterectomy as a minimally invasive treatment option is feasible for treatment of tuberculous nonfunctioning kidneys.
Highlights
Since the initial introduction of laparoscopic nephrectomy in 1991 [1], laparoscopic surgery has made tremendous progress in the urological field
Many complex kidney surgeries such as radical nephrectomy, partial nephrectomy and living donor nephrectomy can be successfully completed by laparoscopic approach, and the safety and effectiveness have been confirmed by several studies [2, 3]
Retroperitoneal laparoscopic nephroureterectomy was successfully completed in 50 patients
Summary
Since the initial introduction of laparoscopic nephrectomy in 1991 [1], laparoscopic surgery has made tremendous progress in the urological field. Laparoscopic nephroureterectomy for tuberculous nonfunctioning kidney has always been a highly challenging procedure because of significant perinephric and perihilum inflammation and severe adhesion with adjacent structures. To the best of our knowledge, several small case series were reported on the outcomes and feasibility of laparoscopic nephroureterectomy for patients with tuberculous nonfunctioning kidneys [4,5,6,7,8]. It is still difficult to ibju | Retroperitoneal Laparoscopic Nephroureterectomy for Tuberculous interpret the overall risk of laparoscopic nephroureterectomy for tuberculous nonfunctioning kidney due to the lack of cases in these reports, and large trials are required to draw definitive conclusions. Few studies dived into whether it is necessary to remove the distal ureter in the laparoscopic nephroureterectomy procedure for the treatment of nonfunctioning tuberculous kidneys
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Schedule a callMore From: International braz j urol : official journal of the Brazilian Society of Urology
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