Minimally invasive nephrectomy for inflammatory renal disease
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 complicati...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-10-01
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| Series: | Asian Journal of Urology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214388219300943 |
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| author | Paula Andrea Peña Lynda Torres-Castellanos Germán Patiño Stefanía Prada Luis Gabriel Villarraga Nicolás Fernández |
| author_facet | Paula Andrea Peña Lynda Torres-Castellanos Germán Patiño Stefanía Prada Luis Gabriel Villarraga Nicolás Fernández |
| author_sort | Paula Andrea Peña |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-7bc98c1fb1504e21b3560e6047b05dc7 |
| institution | Kabale University |
| issn | 2214-3882 |
| language | English |
| publishDate | 2020-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Urology |
| spelling | doaj-art-7bc98c1fb1504e21b3560e6047b05dc72025-08-20T03:48:41ZengElsevierAsian Journal of Urology2214-38822020-10-017434535010.1016/j.ajur.2019.09.002Minimally invasive nephrectomy for inflammatory renal diseasePaula Andrea Peña0Lynda Torres-Castellanos1Germán Patiño2Stefanía Prada3Luis Gabriel Villarraga4Nicolás Fernández5Pontificia Universidad Javeriana, School of Medicine, Bogotá D.C., ColombiaDepartment of Urology, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, School of Medicine, Bogotá D.C., ColombiaDivision of Urology, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá D.C., ColombiaDepartment of Urology, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, School of Medicine, Bogotá D.C., ColombiaDepartment of Urology, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, School of Medicine, Bogotá D.C., ColombiaDivision of Urology, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, School of Medicine, Bogotá D.C., Colombia; Department of Urology, Fundación Santa Fe de Bogotá, Colombia; Division of Urology, Hospital for SickKids, University of Toronto, Toronto, Canada; Corresponding author. Department of Urology, Hospital Universitario San Ignacio and Pontificia Universidad Javeriana, Bogotá D.C., Colombia.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.http://www.sciencedirect.com/science/article/pii/S2214388219300943InflammationKidney diseasesLaparoscopyMinimally invasive surgical proceduresNephrectomyNephritis |
| spellingShingle | Paula Andrea Peña Lynda Torres-Castellanos Germán Patiño Stefanía Prada Luis Gabriel Villarraga Nicolás Fernández Minimally invasive nephrectomy for inflammatory renal disease Asian Journal of Urology Inflammation Kidney diseases Laparoscopy Minimally invasive surgical procedures Nephrectomy Nephritis |
| title | Minimally invasive nephrectomy for inflammatory renal disease |
| title_full | Minimally invasive nephrectomy for inflammatory renal disease |
| title_fullStr | Minimally invasive nephrectomy for inflammatory renal disease |
| title_full_unstemmed | Minimally invasive nephrectomy for inflammatory renal disease |
| title_short | Minimally invasive nephrectomy for inflammatory renal disease |
| title_sort | minimally invasive nephrectomy for inflammatory renal disease |
| topic | Inflammation Kidney diseases Laparoscopy Minimally invasive surgical procedures Nephrectomy Nephritis |
| url | http://www.sciencedirect.com/science/article/pii/S2214388219300943 |
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