COMPARISON OF LAPAROSCOPIC AND OPEN NEPHROURETERECTOMY FOR BENIGN DISEASE

Purpose: We report our experience with laparoscopic nephroureterectomy for benign disease and compare the results to a contemporary group of patients undergoing open nephroureterectomy. Materials and Methods: B etween October 1994 and March 1997, 12 women and 4 men with a mean age of 50 years (range 22 to 70) underwent laparoscopic nephroureterectom y at our hospital. Indications for operation were nonfunctioning kidne ys due to vesicoureteral reflux with recurrent episodes of pyelonephri tis or analgesic nephropathy before a planned renal transplantation. I n comparison 11 women and 4 men with a mean age of 40 years (range 18 to 64) underwent open nephroureterectomy for various benign diseases. Results: Laparoscopic and open nephroureterectomy had no significant d ifferences regarding operative times (100 versus 124 minutes) and comp lication rates (25 versus 20%). In the laparoscopy group conversion to open surgery was not necessary. Patients who underwent laparoscopic n ephroureterectomy had significantly less consumption of morphine equiv alent for postoperative pain control (12 versus 40 mg.), shorter time to achieve mobilization and oral intake (11 versus 39 hours), shorter hospital stay (6 versus 12.7 days) and faster return to normal activit ies (21 versus 39 days). Conclusions: Laparoscopic nephroureterectomy in patients with benign disease has similar operative results but obvi ous postoperative advantages compared to the open approach.