Laparoscopic nephrectomy: Prediction of outcome in relation to the preoperative risk factors in two approaches

Purpose: The data on laparoscopic nephrectomy in Mansoura Urology & Nephrol ogy Center were reviewed to identify the preoperative findings that may pre dict the need for conversion to open surgery. Patients and Methods: One hundred sixty-three patients were subjected to tr ansperitoneal laparoscopic nephrectomy, while 82 underwent retroperitoneal laparoscopic nephrectomy for benign renal diseases. The preoperative demogr aphic data and laboratory and radiologic findings of these patients were co rrelated with failure rate of the laparoscopic procedure. Results: The overall failure rate was 10.4% and 11% for the transperitoneal and retroperitoneal approach, respectively. Positive urine culture, renogr aphic clearance of the removed kidney (> 10 ml/min), and learning curve wer e independently associated with a greater risk of failure in patients under going transperitoneal nephrectomy. For the retroperitoneal approach, a posi tive urine culture, renographic clearance (greater than or equal to 10 ml/m in), and large kidney showed statistical significance. Conclusion: Preoperative data could be used as a predictor of laparoscopic nephrectomy outcome in patients with benign renal diseases. A more experien ced surgeon should be selected for risky cases, bearing in mind the greater potential for early conversion to open surgery.