Introduction of laparoscopic nephrectomy for autosomal dominant polycystic kidney disease as the standard procedure

Abstract

Purpose: Autosomal dominant polycystic kidney disease (ADPKD) is a common hereditary disorder and accounts for 5-10% of all cases of kidney failure. 50% of ADPKD patients reach kidney failure by the age of 58 years requiring dialysis or transplantation. Nephrectomy is performed in up to 20% of patients due to compressive symptoms, renal-related complications or in preparation for kidney transplantation. However, due to the large kidney size in ADPKD nephrectomy can come with a considerable burden. Here we evaluate our institution’s experience of laparoscopic nephrectomy (LN) as an alternative to standard-procedure nephrectomy for ADPKD patients.Materials and Methods: We report the results of the first 12 consecutive laparoscopic cystnephrectomies from 08/2020 to 08/2021 in our institution. Intra- and postoperative parameters were collected and analyzed. Health related quality of life (HRQoL) was assessed using the SF36 questionnaire.Results: Median age of patients was 60 years (±8,1a). Mean preoperative kidney volume measured by volumetric analyzes in abdominal CT scan was 3795ml (range 1255-8253ml). Mean operative time was 158min (range 85-227min). Mean postoperative stay was 11 days (range 6-35 days). Only one postoperative complication Clavien-Dindo ³3 occurred (8,3%). SF36 HRQol questionnaire revealed excellent postoperative quality of life after LN.Conclusion: Laparoscopic nephrectomy in ADPKD patients is a safe and effective operative procedure independent of kidney size with excellent postoperative outcomes and benefits of minimally invasive surgery.