Comparative analysis of postoperative complications of the open, laparoscopic and retroperitoneoscopic nephrectomy

Abstract

Objective. To compare the postoperative complications of open, laparoscopic and retroperitoneoscopic nephrectomies. Materials and methods. The study was conducted on 803 patients who underwent open, laparoscopic and retroperitoneoscopic nephrectomy on the basis of 3 clinics of the Medical Institute of the Peoples’ Friendship University of Russia and in Republican scientific-clinical center «Urology»; Dushanbe, Tajikistan in the period from 2008 to, 2022. Postoperative complications were recorded and classified according to the Clavien-Dindo Classification (CDC). All analyses were performed on SPSS version 21.0 (IBM Corp., Armonk, New York, USA). Results. In the examined groups, no statistically significant differences were found between the operated patients by age, weight, height, body mass index (BMI) and concomitant diseases. Based on the analysis of the table, it can be concluded that the most significant differences were found for the indicator of intestinal damage in the LN group in relation to the PH and TN groups (2.23% and 1.98 %; p = 0.0345 and p = 0.0127); the indicator «Intestinal paresis» in the LN and TN groups in relation to the PH group (3.43% and 7.9%; p = 0.0422 and p = 0.0077); pneumothorax index in the TN group compared to the LN and PH groups (2.08% and 2.45%; p = 0.0123 and p = 0.0177); wound suppuration index in the PH and TN groups relative to the LN group (6.02%) and 10.60%); p < 0.0001 and p < 0.0001); total the rate of complications in the TN group significantly differed in relation to the LN and PH groups (p = 0.0060). Conclusion. In this study, patients after open surgery had a higher percentage of complications, which is associated not only with traumatic access, but also the predominance in this group of patients with purulentinflammatory complications, as well as a large number of operations in the anamnesis.