Comparison of laparoscopic versus open simple nephrectomy in patients with xanthogranulomatous pyelonephritis:A singlecenter analysis of outcomes and predictors of surgical approaches and complications

作     者：Francesco Chiancone Francesco Persico Marco Fabiano Clemente Meccariello Riccardo Giannella Maurizio Fedelini Giovanni Lughezzani Paolo Fedelini Francesco Chiancone;Francesco Persico;Marco Fabiano;Clemente Meccariello;Riccardo Giannella;Maurizio Fedelini;Giovanni Lughezzani;Paolo Fedelini

作者机构：Department of UrologyA.O.R.N.A.CardarelliNaplesItaly Department of UrologyHumanitas Clinical and Research CenterIRCCSRozzanoMilanItaly Department of Biomedical SciencesHumanitas UniversityRozzanoMilanItaly 

出 版 物：《Current Urology》 (当代泌尿学（英文）)

年 卷 期：2023年第17卷第2期

页      面：135-140页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Inflammation Laparoscopy Minimally invasive surgery Nephrectomy Stones Xanthogranulomatous pyelonephritis 

摘      要：Background:The aim ofthis study was to compare the outcomes of open simple nephrectomy and laparoscopic simple nephrectomy in patients with xanthogranulomatous pyelonephritis(XGP)in a single-institutional retrospective study and to identify predictive factors of surgical approaches and *** and methods:We retrospectively analyzed the data of 67 consecutive patients with a histopathological diagnosis of XGP who underwent either open simple nephrectomy(ON)or laparoscopic simple nephrectomy(LN)from January 2014 to April *** primary endpoint was the evaluation of perioperative outcomes and *** endpoints were to define factors influencing the surgical approach and the likelihood of postoperative ***:Overall,44 out of 67 patients(65.67%)underwent ON,while 23(34.33%)underwent *** in the ON group experienced more postoperative pain according to the visual analogic scale(p=0.032).Moreover,time to deambulation and time to return to full daily activities,assessed according to the 12-ltem Short Form Survey physical and mental component summary scores questionnaires,were significantly shorter in the LN group(p=0.021,p0.001,and p0.001,respectively).Of note,there were no significant differences in intraoperative and postoperative complication rates among the groups(p=0.258 and p=0.317,respectively).No conversion to open surgery was *** regression analysis demonstrated that urgency(p=0.025)was the only predictor associated with a higher risk of intraoperative ***,no independent factors associated with postoperative complications or with the surgical approach of choice were ***:Based on our results,laparoscopic treatment of XGP represents a feasible alternative to ON,resulting in less postoperative pain and faster *** skilled hands,LN should be considered as the treatment of choice for XGP.