Naghiyev Rauf, Imamverdiyev Sudeyf, Efendiyev Elchin, Şanlı Öner
Department of Urology, Azerbaijan Medical University, Baku, Azerbaijan.
Department of Urology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey.
Turk J Urol. 2017 Sep;43(3):319-324. doi: 10.5152/tud.2017.21855. Epub 2017 Aug 1.
This retrospective study compares the perioperative outcomes of laparoscopic simple nephrectomy (LSN) in patients with urinary stone disease (USD) in comparison with LSNs performed for other etiological factors.
115 LSNs were identified from the two teaching hospitals' database. Depending on the etiological factors, patients were stratified in 2 groups. Group 1 consisted of 63 (mean age 44.8±1.7 [21-71] years) patients; where the cause of non-functioning kidney was USD. Meanwhile, Group 2 included 52 (mean age was 43.6±2.0 [19-78] years) patients; who underwent LSN because of other benign diseases. In both groups, a standardized transabdominal or retroperitoneal approach was used according to the discretion of the attending surgeon. Two groups were compared statistically in terms of perioperative parameters and standardized surgical complications.
The use of transperitoneal approach was higher in Group 1 (69.8% vs. 30.2%) compared to Group 2 (51.9% vs. 48.1%). Elective open conversion was needed in 3 and 2 patients in Groups 1 and 2, respectively. The results for mean operative time (108.9±4.0 min vs. 106.7±5.0), estimated blood loss (92.5±8.2 vs. 86.8±10.1 mL) and length of hospital stay (4.1±0.33 vs. 3.85±0.42 days) were similar between the groups. Despite intraoperative complications were similar between the groups, overall post-operative complications were significantly higher (17.5% vs. 3.8%) in Group 1. However, the rate of significant complications (Clavien 3-5) was similar between the groups.
The present study revealed that perioperative outcomes of patients undergoing LSN for USD are similar to those seen in patients undergoing LSN for other etiological factors.
本回顾性研究比较了因尿路结石病（USD）行腹腔镜单纯肾切除术（LSN）患者与因其他病因行LSN患者的围手术期结局。
从两家教学医院的数据库中识别出115例LSN患者。根据病因，将患者分为两组。第1组由63例（平均年龄44.8±1.7[21 - 71]岁）患者组成，其无功能肾的病因是USD。同时，第2组包括52例（平均年龄43.6±2.0[19 - 78]岁）患者，他们因其他良性疾病接受了LSN。两组均根据主刀医生的判断采用标准化的经腹或腹膜后入路。对两组患者的围手术期参数和标准化手术并发症进行统计学比较。
第1组经腹入路的使用比例（69.8%对30.2%）高于第2组（51.9%对48.1%）。第1组和第2组分别有3例和2例患者需要择期转为开放手术。两组的平均手术时间（108.9±4.0分钟对106.7±5.0分钟）、估计失血量（92.5±8.2对86.8±10.1毫升）和住院时间（4.1±0.33天对3.85±0.42天）结果相似。尽管两组术中并发症相似，但第1组的总体术后并发症显著更高（17.5%对3.8%）。然而，两组严重并发症（Clavien 3 - 5级）发生率相似。
本研究表明，因USD行LSN患者的围手术期结局与因其他病因行LSN患者的围手术期结局相似。
