Abstract

Outcomes of Laparoscopic Radical Nephrectomy and Factors Predicting Successful Outcomes

Purpose: For renal malignancies, laparoscopic radical nephrectomy is the current standard of care. However, we have observed that a radical nephrectomy is often more challenging than expected even in the most experienced hands. Here, we assess the outcomes that determine a successful radical nephrectomy. Methods: In this retrospective analysis of a prospectively maintained database, between January 2019 and July 2022, patients who had laparoscopic radical nephrectomy were assessed. Total surgical time, intra-operative blood loss postoperative complications, and length of hospital stay were analyzed. Results: Analysis was done on 106 patients. The mean age was 55.33 years ± 12.17 years. Mean operative time 166.79 mins ± 40.11 mins, Blood loss of more than 400 ml was seen in 2 patients (1.8%) and twenty-seven patients required blood transfusions (25%). Conclusion: The term “Simple nephrectomy” is perhaps a misnomer. In a centre of excellence in laparoscopic surgery such as ours, these simple nephrectomies carry longer operative times, comparable rates of surgical complications, and similar hospital stays. Our findings suggest that pre-procedure planning to determine who would benefit most from it is essential while factors such as stone disease or pre-procedure DJ stenting/PCN would perhaps make the procedure more challenging.

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