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53 Laparoscopic nephrectomy for polycystic kidney disease: Comparison of the transperitoneal and retroperitoneal approaches
Title
53
Laparoscopic nephrectomy for polycystic kidney disease: Comparison of the transperitoneal and retroperitoneal approaches Eur Urol Suppl 2015;14/2;e53
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Peyronnet B. 1 , Benoit T.2 , Delreux A. 1 , Sallusto F.2 , Verhoest G.1 , Rischmann P. 2 , Game X. 2 , Bensalah K. 1 1 CHU
Rennes, Dept. of Urology, Rennes, France, 2 CHU Toulouse, Dept. of Urology, Toulouse, France
INTRODUCTION & OBJECTIVES: Nephrectomy in patients with polycystic kidney disease (PKD) can be required for various medical reasons. The use of a laparoscopic approach for extirpation of polycystic kidney has been increasingly reported in recent years via either a transperitoneal or a retroperitoneal route. Our aim was to compare the outcomes of transperitoneal and retroperitoneal laparoscopic approach in patients with PKD. MATERIAL & METHODS: All patients with PKD who underwent a laparoscopic nephrectomy (LN) between 2000 and 2012 in two academic departments were retrospectively included. The transperitoneal route was systematically chosen in the first institution whereas the retroperitoneal approach was preferred in the other department. All procedures were conducted by two highly experienced surgeons who had performed more than 50 laparoscopic procedures before. Major complications were defined as complications Clavien grade ≥ 3. The perioperative parameters were compared between the transperitoneal and retroperitoneal LN groups. RESULTS: Eighty-two patients were included: 43 in the transperitoneal group and 39 in the retroperitoneal group. Sixty-seven patients were on dialysis (81 %). The indication for nephrectomy was preparation of renal transplantation in most cases (60 patients, 73 %). Complication rates (25.6% vs. 33.3%, p=0.44), major complication rates (11.6% vs. 12.8% ; p=0.87), transfusion rates (11.6% vs. 20.5% ; p=0.27) and conversion to open surgery (4.6% vs. 7.7 % ; p=0.56) were similar between the transperitoneal and retroperitoneal groups (see table 1). However, operating time was shorter for transperitoneal procedures (172 vs. 213 min ; p=0.001) and patients in this group had a shorter length of stay (5.3 days vs. 9.3 days ; p=0.0009). There was also a trend toward lower interval from surgery to renal transplantation in the transperitoneal group (7.6 vs. 14.7 months ; p=0.05). CONCLUSIONS: Transperitoneal and retroperitoneal LN provide good outcomes in patients with PKD. The choice of a transperitoneal route could decrease the operating time, length of stay and interval from surgery to renal transplantation.
file:///S|/IM/EURSUP/2015%20EAU%20Abstracts/content/data/53.html[19/02/2015 08:15:20]
53
Laparoscopic nephrectomy for polycystic kidney disease: Comparison of the transperitoneal and retroperitoneal approaches Eur Urol Suppl 2015;14/2;e53
Print! Print!
Peyronnet B. 1 , Benoit T.2 , Delreux A. 1 , Sallusto F.2 , Verhoest G.1 , Rischmann P. 2 , Game X. 2 , Bensalah K. 1 1 CHU
Rennes, Dept. of Urology, Rennes, France, 2 CHU Toulouse, Dept. of Urology, Toulouse, France
INTRODUCTION & OBJECTIVES: Nephrectomy in patients with polycystic kidney disease (PKD) can be required for various medical reasons. The use of a laparoscopic approach for extirpation of polycystic kidney has been increasingly reported in recent years via either a transperitoneal or a retroperitoneal route. Our aim was to compare the outcomes of transperitoneal and retroperitoneal laparoscopic approach in patients with PKD. MATERIAL & METHODS: All patients with PKD who underwent a laparoscopic nephrectomy (LN) between 2000 and 2012 in two academic departments were retrospectively included. The transperitoneal route was systematically chosen in the first institution whereas the retroperitoneal approach was preferred in the other department. All procedures were conducted by two highly experienced surgeons who had performed more than 50 laparoscopic procedures before. Major complications were defined as complications Clavien grade ≥ 3. The perioperative parameters were compared between the transperitoneal and retroperitoneal LN groups. RESULTS: Eighty-two patients were included: 43 in the transperitoneal group and 39 in the retroperitoneal group. Sixty-seven patients were on dialysis (81 %). The indication for nephrectomy was preparation of renal transplantation in most cases (60 patients, 73 %). Complication rates (25.6% vs. 33.3%, p=0.44), major complication rates (11.6% vs. 12.8% ; p=0.87), transfusion rates (11.6% vs. 20.5% ; p=0.27) and conversion to open surgery (4.6% vs. 7.7 % ; p=0.56) were similar between the transperitoneal and retroperitoneal groups (see table 1). However, operating time was shorter for transperitoneal procedures (172 vs. 213 min ; p=0.001) and patients in this group had a shorter length of stay (5.3 days vs. 9.3 days ; p=0.0009). There was also a trend toward lower interval from surgery to renal transplantation in the transperitoneal group (7.6 vs. 14.7 months ; p=0.05). CONCLUSIONS: Transperitoneal and retroperitoneal LN provide good outcomes in patients with PKD. The choice of a transperitoneal route could decrease the operating time, length of stay and interval from surgery to renal transplantation.
file:///S|/IM/EURSUP/2015%20EAU%20Abstracts/content/data/53.html[19/02/2015 08:15:20]