Comparison of Transperitoneal and Retroperitoneal Laparoscopic Nephrectomy for Nonfunctional Tuberculous Kidneys: A Single-Center Experience

J Laparoendosc Adv Surg Tech A. 2018 Mar;28(3):325-329. doi: 10.1089/lap.2017.0270. Epub 2017 Jun 28.

Abstract

Objectives: To compare the effectiveness and safety between retroperitoneal laparoscopic nephrectomy (RLN) and transperitoneal laparoscopic nephrectomy (TLN) for nonfunctional tuberculous kidneys (NTK).

Methods: From March 2013 to February 2016, 24 patients with NTK underwent laparoscopic nephrectomy in our department. Eleven patients underwent RLN, and 13 underwent TLN. The demographics and perioperative outcomes were compared retrospectively.

Results: Characteristics, including gender, age, body mass index, and location, were similar in these two groups. All operations were successfully completed in the RLN group, while 1 case in the TLN group was converted to open surgery due to severe adhesions and excessive bleeding (1 of 13 patients). Time to oral intake after surgery in the TLN and RLN group was 43.85 ± 6.01 hours and 27.45 ± 6.83 hours (P < .05). No notable differences were found between two groups in terms of estimated blood loss, operative time, days of drain removal, and postoperative hospital stay. No local or disseminated recurrence was identified during the follow-up period.

Conclusion: Taking the same safety and effectiveness into consideration, TLN can be an alternative choice for experienced surgeons to deal with NTK. Also, further studies with a larger sample size should be performed to confirm this finding.

Keywords: kidney; laparoscopy; nephrectomy; tuberculosis.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Blood Loss, Surgical
  • Conversion to Open Surgery
  • Eating
  • Female
  • Humans
  • Intraoperative Complications / etiology
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Length of Stay
  • Male
  • Middle Aged
  • Nephrectomy / adverse effects
  • Nephrectomy / methods*
  • Operative Time
  • Postoperative Period
  • Retroperitoneal Space / surgery
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Tuberculosis, Renal / physiopathology
  • Tuberculosis, Renal / surgery*