Minimally invasive nephrectomy for inflammatory renal disease
作者机构：Pontificia Universidad JaverianaSchool of MedicineBogota D.C.Colombia Department of UrologyHospital Universitario San IgnacioPontificia Universidad JaverianaSchool of MedicineBogota D.C.Colombia Division of UrologyHospital Universitario San IgnacioPontificia Universidad JaverianaBogota D.C.Colombia Division of UrologyHospital Universitario San IgnacioPontificia Universidad JaverianaSchool of MedicineBogota D.C.Colombia Department of UrologyFundacion Santa Fe de BogotaColombia Division of UrologyHospital for SickKidsUniversity of TorontoTorontoCanada
出 版 物：《Asian Journal of Urology》 (亚洲泌尿外科杂志（英文）)
年 卷 期：2020年第7卷第4期
页 面：345-350页
主 题：Inflammation Kidney diseases Laparoscopy Minimally invasive surgical procedures Nephrectomy Nephritis Nephroureterectomy
摘 要：Objective:Once chronic inflammatory renal disease(IRD)develops,it creates a severe peri-fibrotic process,which makes it a relative contraindication for minimally invasive surgery(MIS).Our objective is to show that laparoscopic nephrectomy(LN)is a surgical option in IRD with fewer complications and better outcomes.Methods:Retrospective review of patients who underwent a modified-surgical laparoscopic transperitoneal nephrectomy was performed.Data search included all operated patients between May 2013 and May 2018 that had a pathology result with any renal inflammatory condition(xanthogranulomatous pyelonephritis,chronic nephritis,and renal tuberculosis).We describe intra-operative variables such as operative time,blood loss,conversion rate,postoperative complications and length of hospital stay.Results:There were 51 patients who underwent laparoscopic nephrectomy with a confirmatory pathology report for IRD.We identified four(8%)major complications;three of them required transfusion and one conversion to open surgery.The mean operative time was 233108 min.Mean estimated blood loss was 206242 mL excluding the conversion cases and 281423 mL including them.The mean length of hospital stay was 3.02.0 days.Conclusion:Laparoscopic nephrectomy for IRD can safely be done.It is a reproducible technique with low risks and complication rates.Our experience supports that releasing the kidney first and leaving the hilum for the end is a safe approach when vascular structures are embedded into a single block of inflammatory and scar tissue.
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