Laparoscopic Nephrectomy in Patients Undergoing Hemodialysis Treatment

Overview

Journal JSLS

Specialty General Surgery

Date 2011 May 25

PMID 21605518

Citations 1

Authors

Oner Sanli

Tzevat Tefik

Mazhar Ortac

Meltem Karadeniz

Tayfun Oktar

Ismet Nane

Murat Tunc

Affiliations

Soon will be listed here.

Abstract

Background And Objectives: To report our experience with laparoscopic nephrectomy (LN) in patients undergoing hemodialysis compared with normal counterparts.

Methods: Seventeen patients (20 renal units, Group 1) undergoing hemodialysis underwent LN, which was indicated due to nonfunctioning kidney in 17 and suspected malignancy in 3 renal units. Radical nephrectomy (RN), simple nephrectomy (SN), and simple nephroureterectomy (SNU) were performed in 3, 9, and 8 cases, respectively. For comparison, 101 patients (Group 2) without CRF (chronic renal failure) who had undergone LN were evaluated. In this group, RN, SN, SNU and radical nephroureterectomy (RNU) were performed in 48, 41, 8, and 4 patients, respectively.

Results: The mean age (36.9 ±13.1 vs. 48.7±19.4yr, P=0.002) and BMI (22.1±4.8 vs. 26.2±5.1kg/m(2), P=0.001) were lower in Group 1, whereas ASA (physical status score of American Society of Anesthesiologists) score (2.8±0.4 vs. 1.5±0.7, P<0.001) was lower in Group 2. The estimated blood loss (111±114 vs. 184±335mL, P=0.34) was higher in Group 2. Both groups were comparable in regard to mean operative time (133±79 vs. 119±45, P±0.70), hematocrit drop (4.69±3.9 vs. 3.86±3.0, P=0.29) and hospital stay (3.6±3.3 vs. 3.3±2.4 days, P=0.34). Meanwhile, when only patients undergoing SN and SNU in the study cohort (n=17 in Group 1 and n=49 in Group 2) are taken into consideration, no significant difference was observed between the 2 groups in terms of any kind of above-mentioned perioperative parameters. No case in Group 1 was converted to open surgery due to metabolic problems.

Conclusions: LN in patients undergoing hemodialysis may be performed safely by an experienced laparoscopy team.

Citing Articles

Laparoscopic transperitoneal and retroperitoneal simple nephrectomy: The impact of etiological factors of the results of surgical treatment.

Naghiyev R, Imamverdiyev S, Efendiyev E, Sanli O Turk J Urol. 2017; 43(3):319-324.

PMID: 28861305 PMC: 5562252. DOI: 10.5152/tud.2017.21855.

References

Keeley F, Tolley D . A review of our first 100 cases of laparoscopic nephrectomy: defining risk factors for complications. Br J Urol. 1998; 82(5):615-8. DOI: 10.1046/j.1464-410x.1998.00847.x. View

Goel R, Modi P, Dodia S . Retroperitoneoscopic pre-transplant native kidney nephrectomy. Int J Urol. 2006; 13(4):337-9. DOI: 10.1111/j.1442-2042.2006.01311.x. View

Pace K, Dyer S, Stewart R, Honey R, Poulin E, Schlachta C . Health-related quality of life after laparoscopic and open nephrectomy. Surg Endosc. 2002; 17(1):143-52. DOI: 10.1007/s00464-002-8902-y. View

Dunn M, Portis A, Shalhav A, Elbahnasy A, Heidorn C, McDougall E . Laparoscopic versus open radical nephrectomy: a 9-year experience. J Urol. 2000; 164(4):1153-9. View

Ekman L, Abrahamsson J, Biber B, FORSSMAN L, Milsom I, Sjoqvist B . Hemodynamic changes during laparoscopy with positive end-expiratory pressure ventilation. Acta Anaesthesiol Scand. 1988; 32(6):447-53. DOI: 10.1111/j.1399-6576.1988.tb02764.x. View

Castillo R, Lozano T, Escolar G, Revert L, Lopez J, Ordinas A . Defective platelet adhesion on vessel subendothelium in uremic patients. Blood. 1986; 68(2):337-42. View

Demian A, Esmail O, Atallah M . Acid-base equilibrium during capnoretroperitoneoscopic nephrectomy in patients with end-stage renal failure: a preliminary report. Eur J Anaesthesiol. 2000; 17(4):256-60. DOI: 10.1046/j.1365-2346.2000.00636.x. View

Darby C, Cranston D, Raine A, Morris P . Bilateral nephrectomy before transplantation: indications, surgical approach, morbidity and mortality. Br J Surg. 1991; 78(3):305-7. DOI: 10.1002/bjs.1800780313. View

Fornara P, Doehn C, Miglietti G, Fricke L, Steinhoff J, Sack K . Laparoscopic nephrectomy: comparison of dialysis and non-dialysis patients. Nephrol Dial Transplant. 1998; 13(5):1221-5. DOI: 10.1093/ndt/13.5.1221. View

10.

Shoma A, Eraky I, El-Kappany H . Pretransplant native nephrectomy in patients with end-stage renal failure: assessment of the role of laparoscopy. Urology. 2003; 61(5):915-20. DOI: 10.1016/s0090-4295(02)02556-6. View

11.

Eraky I, Ghoneim M . Laparoscopic nephrectomy: Mansoura experience with 106 cases. Br J Urol. 1995; 75(3):271-5. DOI: 10.1111/j.1464-410x.1995.tb07336.x. View

12.

Dindo D, Demartines N, Clavien P . Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004; 240(2):205-13. PMC: 1360123. DOI: 10.1097/01.sla.0000133083.54934.ae. View

13.

Taweemonkongsap T, Nualyong C, Amornvesukit T, Srinualnad S, Sujijantararat P, Soontrapa S . Retroperitoneoscopic nephrectomy in dialysis dependent patients and comparison with open surgery. J Med Assoc Thai. 2009; 91(11):1719-25. View

14.

Gaur D, Agarwal D, Purohit K . Retroperitoneal laparoscopic nephrectomy: initial case report. J Urol. 1993; 149(1):103-5. DOI: 10.1016/s0022-5347(17)36012-3. View

15.

Lindsay R, Moorthy A, Koens F, Linton A . Platelet function in dialyzed and non-dialyzed patients with chronic renal failure. Clin Nephrol. 1975; 4(2):52-7. View