[Retrospective comparative study of extended nephrectomies by surgery and by retroperitoneal laparoscopy].

OBJECTIVE

To evaluate the results of radical retroperitoneal laparoscopic nephrectomy in terms of tolerance, morbidity and oncologic control.

MATERIAL AND METHODS

22 radical nephrectomies have been carried out by retroperitoneal laparoscopy. One surgical conversion has been necessary. This series has been retrospectively compared to 16 radical nephrectomies by open surgery.

RESULTS

Both series were comparable. Operative time was not significantly different in the two groups. Blood loss was less with laparoscopic surgery (p < 10-3). We did not see any difference in antalgic consumption during the first post-operative day and in intensive care and hospital stay. Post-operative complications were less in the laparoscopy group (p = 0.04). We observed no death or reccurrence with a mean follow-up of 8.7 months for the laparoscopy group vs 32.2 for the open group.

CONCLUSIONS

Radical retroperitoneal laparoscopic nephrectomy is a recent surgical technique which has the same oncologic standards as open surgery. Blood loss and post-operative complications are significantly reduced. Survival needs to be evaluated on long term follow-up.