The emerging role of laparoscopic nephrectomy in the operative management of renal trauma: is less really more?

Abstract

The role of laparoscopic nephrectomy (LN) is well established in the operative armamentarium of renal surgery and has also extended to the resection of benign and malignant renal neoplasms. Despite growing evidence advocating conservative management of renal trauma, the role of LN in the management of renal trauma is not well defined. Thus, a systematic review was conducted to better define the role of LN in the subgroup of renal trauma patients requiring operative nephrectomy. In accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, a comprehensive literature search was performed (March 2020), using the following databases: Cochrane library of systematic reviews, EMBASE, PubMed, Scopus, and web of science. Included studies were further assessed for relevance and quality using the Oxford 2010 critical appraisal skills program (CASP). A total of 620 studies were identified, non-relevant and non-English articles were excluded which resulted in 4 relevant articles being included. Due to a relative lack of data, case reports and case series were also included. The role of LN is a viable option in a select group of cases when operative intervention is already planned for advanced renal injury. The special considerations and relative contraindications to laparoscopy must be adhered to when selecting this modality in the setting of renal trauma. Future prospective studies are required to better define this relationship.