Laparoscopic nephrectomy for xanthogranulomatous pyelonephritis – Are there predictive factors for success?

Lima, Marcelo Lopes de; Miyaoka, Ricardo; Moro, Juliano César; D’Ancona, Carlos

doi:10.6061/clinics/2012(08)09

Cited by 16 publications

(17 citation statements)

References 11 publications

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“…Lima et al . [ 8 ] in 2012, in the largest series for reported for XGN of 66 patients have reported a conversion rate of 12.1%. Conversions were found to be due to technical difficulty.…”

Section: Discussionmentioning

confidence: 99%

“…Benign indications include nephrolithiasis, renal dysplasia, pelvi-ureteric junction (PUJ) obstruction, chronic pyelonephritis, tuberculosis, vesicoureteric reflux, ureterocele, polycystic kidney, and xanthogranulomatous pyelonephritis (XGN). [ 6 7 8 9 10 11 12 ] Although literature supports improved learning curves and outcomes[ 13 14 ] compared to early 1990s,[ 15 ] laparoscopic nephrectomy is still not well established for benign cases. With the reporting of improved results,[ 16 17 18 ] we hereby present our experience.…”

Section: Introductionmentioning

confidence: 99%

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This challenging procedure has successful outcomes: Laparoscopic nephrectomy in inflammatory renal diseases

Jain

Kaza

et al. 2018

Urol Ann

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In prospective study from November 2011- November 2013, we performed 44 laparoscopic nephrectomies for benign non-functioning kidney diseases. Twenty eight patients underwent laparoscopic transperitoneal nephrectomies (63.6%), ten were laparoscopic assisted (22.7%) and six (13.6%) were converted to open. Patient's age, gender, laterality and etiology of renal failure were noted. Outcomes were measured as operative time, intraoperative and post operative complications, blood loss, pain score and hospital stay. Patients were followed up at one, three and 12 weeks and 6 monthly thereafter. Of the 44, ten (22.7%) were 15-24 years old, 32 (72%) between 25-50 years and two were more than 50 years old. Females were 54.6%. 22 patients had either right or left nephrectomy. Pelviureteric-junction (PUJ) obstruction was the commonest cause, 26 cases (59.0%). Operative time: less than two hours in 30 (68.2%) patients, more than two hours in 14 cases. Blood loss: less than 100 ml in 12 (27.3%), 100-200 ml in 20 (45.4%) and more than 200 ml in 12 (27.3%) patients. All four major complications were converted to open, two had injury to mesocolic veins and two had vascular stapler malfunction. Post-operative complications: surgical site infection (SSI), paralytic ileus and mild grade fever in six cases each and non infected benign intra abdominal collection in two cases. Maximum pain score on POD-1: four in 20 cases (45.7%), two in 24 (54%). Two had pain score between 3-4 three weeks after surgery. Oral intake started by POD-2 in 30 (68.2%) and by POD-4 in 100% cases. 22 (50%) patients were ambulating by POD-2, 16 (36.7%) by POD-4. Our study and randomized and non-randomized published literature report acceptables complication and conversion rates. In conclusion, laparoscopic nephrectomy for benign non functional kidney is a better alternative to open nephrectomy

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“…Lima et al . [ 8 ] in 2012, in the largest series for reported for XGN of 66 patients have reported a conversion rate of 12.1%. Conversions were found to be due to technical difficulty.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

This challenging procedure has successful outcomes: Laparoscopic nephrectomy in inflammatory renal diseases

Jain

Kaza

et al. 2018

Urol Ann

View full text Add to dashboard Cite

show abstract

“…Lima et al. [22] found that the time to control renal vessels (32±18 min), renal length greater than 12 cm and right-sided nephrectomy were some predictive factors associated with a higher conversion rate in laparoscopic approach. In our cohort, there were six cases of XGP, with only one conversion, one severe intraoperative complication (diaphragmatic perforation) and no postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive nephrectomy for inflammatory renal disease

Peña

Torres-Castellanos

Patiño

et al. 2020

Asian Journal of Urology

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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 233±108 min. Mean estimated blood loss was 206±242 mL excluding the conversion cases and 281±423 mL including them. The mean length of hospital stay was 3.0±2.0 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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“…Indications for LN include nephrolithiasis, renal dysplasia, pelvi-ureteric junction obstruction, chronic pyelonephritis, tuberculosis, vesicoureteric reflux, ureterocele, polycystic kidney, and xanthogranulomatous pyelonephritis. [1][2][3][4][5][6] Ipsilateral LN has been reported in patients with a history of surgical intervention. Turna et al 7 reported the feasibility of laparoscopic partial nephrectomy after previous ipsilateral renal surgery; furthermore, Aminsharifi and Goshtasbi 8 reported that the difficulties associated with LN were similar for patients with previous percutaneous nephrolithotomy compared with those with previous open renal surgery.…”

Section: Introductionmentioning

confidence: 99%

Comparative Study of Retroperitoneal Laparoscopic Versus Open Ipsilateral Nephrectomy After Percutaneous Nephrostomy: A Multicenter Analysis

Wang

Tian

Yue

et al. 2020

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Purpose: To investigate the feasibility of retroperitoneal laparoscopic ipsilateral nephrectomy of a benign nonfunctional kidney after percutaneous nephrostomy, and to compare this method with open surgery. Materials and Methods: Data from 70 patients who underwent simple nephrectomy from January 2014 to October 2018 at three large centers were retrospectively analyzed. All patients underwent percutaneous nephrostomy because of renal or ureteral calculi with severe hydronephrosis or pyonephrosis. Simple nephrectomy was performed via retroperitoneal laparoscopic surgery (retroperitoneal laparoscopic group; n = 33) or open surgery (open group; n = 37). The retroperitoneal laparoscopic and open groups were compared regarding preoperative variables (age, sex, location of surgery, hypertension, diabetes, BMI, preoperative serum creatinine level, American Society of Anesthesiologists (ASA) grade, fistula duration, fistula size, number of fistulae, and urinary tract infection), and perioperative variables (operation time, intraoperative blood loss, postoperative drainage volume, catheter indwelling time, gastrointestinal function recovery time, duration of bedrest, duration of postoperative hospitalization, postoperative hemoglobin decline, perioperative transfusion, and postoperative complications). Results: The retroperitoneal laparoscopic group included more patients with hydronephrosis, while the open group included more patients with pyonephrosis. There were no significant differences between the two groups in age (P = .813), sex (P = .729), location of surgery (P = .345), hypertension (P = .271), diabetes (P = .394), BMI (P = .798), preoperative serum creatinine level (P = .826), ASA grade (P = .820), fistula duration (P = .108), fistula size (P = .958), number of fistulae (P = .925), urinary tract infection (P = .111), or operative time (P = .851). The retroperitoneal laparoscopic group had significantly lesser intraoperative blood loss (P = .007), postoperative drainage volume (P = .008), shorter catheter indwelling time (P = .002), gastrointestinal function recovery time (P < .001), duration of bedrest (P < .001), and duration of postoperative hospitalization (P < .001), and lesser postoperative hemoglobin decline (P = .035) compared with the open group. Conclusions: Retroperitoneal laparoscopic ipsilateral nephrectomy is feasible for a benign nonfunctional kidney after percutaneous nephrostomy. The surgical method should be selected based on the surgeon's experience and the specific situation of the patient.

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Laparoscopic nephrectomy for xanthogranulomatous pyelonephritis – Are there predictive factors for success?

Cited by 16 publications

References 11 publications

This challenging procedure has successful outcomes: Laparoscopic nephrectomy in inflammatory renal diseases

This challenging procedure has successful outcomes: Laparoscopic nephrectomy in inflammatory renal diseases

Minimally invasive nephrectomy for inflammatory renal disease

Comparative Study of Retroperitoneal Laparoscopic Versus Open Ipsilateral Nephrectomy After Percutaneous Nephrostomy: A Multicenter Analysis

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