Laparoscopic Nephroureterectomy for Tuberculous Nonfunctioning Kidneys Compared with Laparoscopic Nephroureterectomy for Other Diseases

Chibber, Percy Jal; Shah, Hemendran N.; Jain, Pritesh

doi:10.1089/lap.2005.15.308

Cited by 14 publications

(13 citation statements)

References 12 publications

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“…In our cases, we performed all surgeries by retroperitoneal laparoscopic approach for we have high volume of experience with this approach ( 12 ). Current researches have demonstrated that the laparoscopic operation for inflammatory nonfunctioning kidney can be accomplished through either the transperitoneal or the retroperitoneal approaches ( 5 , 7 ), and the choice depends mainly on the surgeon’s educational background and laparoscopic experiences. Although the retroperitoneal approach has some disadvantages such as the limited working space, difficulty to identify the anatomical structure as well as a longer learning curve compared to the transperitoneal approach, it facilitates to control renal vessels early and avoids contamination with the pus and potential injury to intraperitoneal organs ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

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Retroperitoneal Laparoscopic Nephroureterectomy for Tuberculous Nonfunctioning Kidneys: a single-center experience

et al. 2015

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Purpose To present our surgical techniques and experiences of retroperitoneal laparoscopic nephroureterectomy for the treatment of tuberculous nonfunctioning kidneys.Materials and Methods From March 2005 to March 2013, a total of 51 patients with tuberculous nonfunctioning kidney underwent retroperitoneal laparoscopic nephroureterectomy at our medical center. The techniques included early control of renal vessels and dissection of the diseased kidney along the underlying layer outside the Gerato’s fascia. The distal ureter was dissected through a Gibson incision and the entire specimen was removed en bloc from the incision. Patient demographics, perioperative characteristics and laboratory parameters as well as postoperative outcome were retrospectively reviewed.Results Retroperitoneal laparoscopic nephroureterectomy was successfully performed in 50 patients, whereas one case required conversion to open surgery due to non-progression of dissection. The mean operating time was 123.0 minutes (107-160 minutes) and the mean estimated blood loss was 134 mL (80-650 mL).The mean postoperative hospital stay was 3.6 days (3-5days) and the mean return to normal activity was 11.6 days (10-14days). Most intra-operative and post-operative complications were minor complications and can be managed conservatively. After 68 months (12-96 months) follow-up, the outcome was satisfactory, and ureteral stump syndrome did not occur.Conclusions Retroperitoneal laparoscopic nephroureterectomy as a minimally invasive treatment option is feasible for treatment of tuberculous nonfunctioning kidneys.

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Section: Discussionmentioning

confidence: 99%

“…Only a few small series have been reported addressing laparoscopic nephroureterectomy for tuberculous nonfunctioning kidneys. The reported rates of successive laparoscopic surgery were between 77.8% and 100% ( 5 - 8 ). The largest cohort included only 31 patients ( 7 ).…”

Section: Discussionmentioning

confidence: 99%

Retroperitoneal Laparoscopic Nephroureterectomy for Tuberculous Nonfunctioning Kidneys: a single-center experience

et al. 2015

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“…In laparoscopic nephrectomy procedures for tuberculous nonfunctioning kidneys, the main reasons for conversion to open surgery are perinephric adhesions and intraoperative major hemorrhages. 9 Many investigators have regarded the tuberculous nonfunctioning kidney as a relative contraindication for laparoscopic nephrectomy because of the difficulty in dissection, high conversion rate, and the risk of spillage of caseous materials with subsequent dissemination of the disease. 10 In the present study, the most difficult part of the procedure was dissection of the dense adhesions and all the surgical steps.…”

Section: Discussionmentioning

confidence: 99%

Clinical analysis of retroperitoneoscopic nephroureterectomy for renal tuberculosis

Yan

et al. 2015

Chronic Diseases and Translational Medicine

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ObjectivesTo explore the feasibility and safety of retroperitoneoscopic nephroureterectomy for kidney tuberculosis.MethodsForty-eight retroperitoneoscopic nephroureterectomies and thirty-five nephroureterectomies for kidney tuberculosis procedures were performed from June 2008 to December 2014. The patients consisted of 53 males and 30 females with a mean age of 36 years (range: 26–51 years). The patients' data were reviewed and analyzed.ResultsThe retroperitoneoscopic nephroureterectomy procedures were completed successfully in 48 cases with no conversions to open surgery. The mean operating time was 170 minutes (range: 121–258 minutes), the mean blood loss was 110 ml (range: 70–250 ml), and the mean hospital stay was 5.70 days (range: 5–14 days); these were all much less than nephroureterectomy procedures (P < 0.05). A total of five minor complications (10.4%) occurred, injury to the peritoneum was observed in three patients, and infection at the incision site was observed in two patients, there were no obvious difference between the two surgical methods (P > 0.05). Seventy-five patients were followed up, and the average follow-up time was 12.5 months (range: 6–20 months). All the patients recovered without any lesions remaining.ConclusionsThe results of this study indicate that retroperitoneoscopic nephroureterectomy is a feasible, safe, effective, and less invasive treatment modality for treating renal tuberculosis.

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“…1 Many of these problems requiring surgical intervention can now be managed by present-day laparoscopic techniques, providing the well-known benefits of minimally invasive surgery to the patient. These problems lead to difficulty in dissection because of poor anatomic landmarks.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Ablative and Reconstructive Surgeries in Genitourinary Tuberculosis

Dorairajan

Muruganandham

Manikandan

et al. 2014

JSLS

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Background and Objectives:Laparoscopy is the present standard of care for urologic diseases. Laparoscopy in renal tuberculosis (genitourinary tuberculosis) is difficult because of inflammation and fibrosis associated with the disease. We present the outcome of our experience of laparoscopy in genitourinary tuberculosis, both ablative and reconstructive.Methods:The detailed data of patients with genitourinary tuberculosis who underwent laparoscopic surgeries between January 2011 and September 2012 were reviewed. Indications, type of surgery, duration, blood loss, intraoperative problems, postoperative outcomes, and follow-up details were noted.Results:Overall, 7 laparoscopic procedures were performed: 5 nephrectomies, 1 ureteric reimplantation with psoas hitch, and 1 combined nephrectomy and laparoscopy-assisted Mainz II pouch reconstruction. The mean operative time was 192 minutes for nephrectomy, 210 minutes for ureteric reimplantation, and 480 minutes for nephrectomy with Mainz II pouch reconstruction. There were no conversions to open surgery. The mean amount of blood loss was 70 mL for the nephrectomies, 100 mL for ureteric reimplantation, and 200 mL for nephrectomy with Mainz II pouch reconstruction. In 5 of 6 patients who underwent nephrectomy, there was severe perinephric and peripelvic fibrosis posing difficulty in dissection. However, the renal vessels could be controlled individually. The mean postoperative hospital stay was 3 days for the nephrectomies, 5 days for the ureteric reimplantation, and 10 days for the nephrectomy with Mainz II pouch reconstruction. In all cases the recovery was uneventful.Conclusions:Laparoscopy, though technically more demanding, is a feasible and safe option for ablative and complex reconstructive procedures in genitourinary tuberculosis. It offers the benefits of minimally invasive surgery. The difficulty with this procedure is mostly because of peripelvic and perinephric fibrosis, whereas the lower ureter and bladder are relatively easier to dissect.

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Laparoscopic Nephroureterectomy for Tuberculous Nonfunctioning Kidneys Compared with Laparoscopic Nephroureterectomy for Other Diseases

Cited by 14 publications

References 12 publications

Retroperitoneal Laparoscopic Nephroureterectomy for Tuberculous Nonfunctioning Kidneys: a single-center experience

Retroperitoneal Laparoscopic Nephroureterectomy for Tuberculous Nonfunctioning Kidneys: a single-center experience

Clinical analysis of retroperitoneoscopic nephroureterectomy for renal tuberculosis

Laparoscopic Ablative and Reconstructive Surgeries in Genitourinary Tuberculosis

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