TRANSPERITONEAL NEPHRECTOMY FOR BENIGN DISEASE OF THE KIDNEY - A COMPARISON OF LAPAROSCOPIC AND OPEN SURGICAL TECHNIQUES

Objective. The objective of this study was to compare the results of l aparoscopic nephrectomy for benign disease to open surgical nephrectom y for benign disease. Methods. Twenty consecutive patients undergoing laparoscopic nephrectomy for benign disease were compared with 23 pati ents undergoing open surgical nephrectomy for benign disease and with 29 patients undergoing a donor nephrectomy. Data were collected in the following areas: patient age, anesthetic risk, operative time, estima ted blood loss, postoperative time to resume oral intake, parenteral a nalgesics, oral analgesics, hospital stay, complications, and convales cence. Information was obtained through chart review, telephone interv iews, and mailed questionnaires. Results. Compared with open surgical nephrectomy, laparoscopic nephrectomy resulted in a statistically sign ificant longer operative time; however, it afforded a statistically si gnificant decrease in postoperative ileus (open group), hospital stay (both groups), oral analgesics (donor group), and convalescence (both groups). The incidence of complications was 1 5 percent in the laparos copic group and 0 percent in the two open surgical groups; the majorit y of complications occurred during the initial seven laparoscopic proc edures. Conclusions. Laparoscopic nephrectomy is a more time-consuming procedure than open surgical nephrectomy. Also, early in one's experi ence with this technique, the complication rate is higher than with op en surgery. However, despite the newness of the technique, it results in significant benefits to the patient: decreased postoperative pain, shorter hospitalization, and more rapid convalescence.