Laparoscopic nephrectomy in inflammatory renal disease: proposal for a staged approach

Abstract

The laparoscopic nephrectomy for inflammatory renal disease is feasible, but presents a high degree of complexity, requiring a customized approach. The use of hand assistance is an attractive option when the inflammatory process is intense, and can avoid conversions, maintaining the advantages of minimally invasive treatments.

Xanthogranulomatous pyelonephritis: critical analysis of 30 patients

“…Though it is bothersome for patients to carry a drain tube for 2-4 weeks, the staged operation is safer and patients can resume better nutrition during the drainage phase, which also results in less inflammatory stress. Whether to perform laparoscopic or open nephrectomy depends on the surgeon's experience and remains controversial [14,15]. Among patients with focal XGP, none was diagnosed pre-operatively and this poses a tremendous clinical challenge.…”

“…A definitive diagnosis of XGP is only reached by pathological examination [12,13]. Enhancing the accuracy of preoperative diagnosis of XGP would help clinicians and surgeons prepare optimal surgical approaches [14,15]. In this retrospective study of 30 patients, the clinical, surgical, and radiologic characteristics of XGP are highlighted and we also give the emphasis to the association between XGP and overweight.…”

Complicated Upper Urinary Tract Infection

“…Laparoscopic nephrectomy has been concluded as a reasonable approach to the treatment of xanthogranulomatous pyelonephritis in some literature reviews, but the fact is that most XPN cases were managed through open surgery and the conversion rate was high in those few cases that laparoscopic approach had been tried [159,167].…”

Hand-assisted laparoscopic nephrectomy as a minimally invasive option in the treatment of large renal specimens

“…The difficult access to the kidney limits, the contiguous fibrosis and the difficult in identifying the renal vessels lead to longer operating times and higher complication and conversion rates when surgery is performed through pure laparoscopic technique (1,2).…”