The use of laparoscopic nephrectomy in patients with autosomal dominant polycystic kidney disease

Abstract

The study analyzed the results of treatment of 32 patients with autosomal dominant polycystic kidney disease (PKD). In the period from 2014 to 2016 these patients underwent nephrectomy for clinical indications and in preparation for renal transplantation. The first group (15 patients) performed open surgery using midline laparotomy and lumbotomy (16 operations), of which: bilateral nephrectomy - 11 (68.7%), monolateral nephrectomy - 5 (31.3%). In the second group (17 patients) to perform a monolateral nephrectomy used laparoscopic transabdominal access (24 operations). The average duration of laparoscopic and open surgical interventions were not significantly different and amounted to 146 ± 14 and 134±15 min (p > 0.05). The maximum size of the deleted polycystic-changed kidneys in the first group amounted to 22.5 ± 4.27 cm, in the second of 21.5 ± 3.9 cm (p > 0.05). The frequency of postoperative complications in the first and second groups consisted of 43.75% and 12.5%, respectively. Was observed in 1 (6.25%) case of lethal outcome in the first group. Average postoperative hospital stay in the first group 13-14 (to 13.7 ± 1.3), in the second - 7-8 (7.6 ± 0.4, p < 0.05). Patients after laparoscopic procedures activated in 2-3 days (2.5 ± 0.13) after open procedures on 4-5 (4.13 ± 0.39, p < 0.05). Laparoscopic technology can significantly reduce the frequency of postoperative complications and increase the possibility of the use of nephrectomy in the treatment of patients with PKD. Laparoscopic transabdominal approach is characterized by a more favorable course of the postoperative period after nephrectomy, can reduce the duration of inpatient treatment and to activate patients in the early stages.