DOI: 10.21276/sasjs.2019.5.5.1

Pages: 225-228

Laparoscopic nephrectomy is procedure of choice for variety of indications ranging from non functioning infected, non-infected kidney and renal tumour. We performed this study to analyze perioperative difficulties and postoperative complications after Laparoscopic nephrectomies done for these different type of indications. Retrospective analysis of records of patients who underwent Laparoscopic Nephrectomy (LN) at a single centre from August 2010 to August 2013 was done. The indications were divided into three categories; kidneys with no infection/tumor (Group 1), Grossly Infected/Inflammed (Group2) and tumor bearing kidneys (Group3). Group 1, 2 and 3 had 27, 18 and 10 patients respectively. Conversion rate to open nephrectomy in three groups were; 7% (2/27), 28% (5/18) and 40% (4/10) respectively and it was higher in group 2 and 3 compared to group 1. Mean operative time in group2 and 3 were 125 min and 112 min respectively which were significantly higher when compared to group1 (86min, p<0.0001.) Blood transfusion rate were similar in group2 and group3 (22.2% and 20%) while group1 required no transfusion. Postoperative hospital stay were 4.9(3-8), 6.6(3-21) and 6.9(4-10) in Group1, 2 and 3 respectively (p=0.0520). Wound infection rate in group2 was 22.2% as compared to 3% in group1 (p=0.147). Group 2 in addition had 2 colonic injuries and 4 patients had abdominal collection requiring drainage. Postoperative hospital stay were 4.9(3-8), 6.6(3-21) and 6.9(4-10) in gr1, 2 and 3 respectively (p=.0520). We concluded that LN for Infected kidneys has longer operative time, higher conversion rate and morbidity. Hence these patients require more meticulous preoperative preparation and threshold for conversion to open must be lower in these patients.