Laparoscopic Nephrectomy Results in Better Postoperative Pulmonary Function

Abstract

The pulmonary response to nephrectomy was studied in 16 patients undergoing laparoscopic (n = 8) or open (n = 8) nephrectomy using a standardized anesthetic technique. Although there was no significant difference between the two groups at 24 hours, postoperative pulmonary function measures (P = 0.02-0.03) and oxygenation (P = 0.03) were significantly better in the laparoscopic surgery group at 48 hours. The median opiate analgesic requirement (P = 0.02) and the number of nights spent in the hospital (P = 0.003) also were significantly lower in this group. The results of this study suggest that laparoscopic nephrectomy offers a real biological advantage in terms of postoperative preservation of lung function and that this might therefore be the safest technique for nephrectomy in patients with limited respiratory reserves.

The efficacy and safety of laparoscopic nephrectomy in patients with three or more comorbidities

“…Eden et al reported that the pulmonary function after laparoscopic nephrectomy was better than after open nephrectomy. 8 However, creating a pneumoperitoneum can cause cardiovascular changes similar to those of heart failure. 9 The increase in both systemic and pulmonary vascular resistances raises the cardiac afterload , which results in a decrease in cardiac output.…”

Laparoscopic nephrectomy in childrenrid=""id=""Presented in poster format at the annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES), San Antonio, Texas, USA, 24–27 March 1999

“…Many of its benefits are the same ones that have been demonstrated for other, more common laparoscopic procedures (e.g., cholecystectomy, fundoplication, etc.) [2]. Significant advantages include shortened hospitalization, decreased morbidity, minimal analgesic requirement, rapid return to full activity, and improved cosmetic outcome.…”

The Role of the Anesthesia Team in the Avoidance, Diagnosis, Management, and Genesis of Laparoscopic Complications

“…It has not yet been possible, however, to assemble all of the available pieces in one project, and many pieces are missing altogether. 7,8 It also results in less pain, 9 shorter hospital stays, 10,11 lower hospital costs, 12 quicker return to activities of daily living, 13 improved postoperative pulmonary function, [14][15][16][17][18] and smaller incisional scars. These factors contribute to an environment in which patient safety cannot be assumed.…”