Keshavamurthy Ramaiah, Gupta Avneet, Manohar C S, Karthikeyan V S, Singh Vinish K
Department of Urology, Institute of Nephrourology, Bangalore, Karnataka, India.
J Family Med Prim Care. 2022 Mar;11(3):1059-1062. doi: 10.4103/jfmpc.jfmpc_1014_21. Epub 2022 Mar 10.
The word "simple" means "easily done" or "presenting no difficulty." Hence, the "Simple Nephrectomy" (SN) operation should be "easy to perform." However, in clinical practice, we have noticed that SN can be equally or more challenging surgery than radical nephrectomy (RN). This study assesses the need to modify the terminology of simple nephrectomy and identify the level of difficulty between SN and RN by comparing various intraoperative and postoperative factors.
Patients undergoing open SN for benign renal disease (Group A) and RN for T1/2 renal tumors (Group B) were included in the study. Two groups were compared for operative time, estimated blood loss, postoperative complications, blood transfusion rate, and length of hospital stay.
A total of 114 patients were analyzed (82 in Group A and 32 in Group B). Mean age of the patients was higher in Group B (41.2 vs 53.6 years, < 0.01). Mean operative time (136.8 vs 125.5 min, = 0.08), incidence of postoperative complications (32.9% vs 25%, = 0.50), length of hospital stay (7.2 vs 6.5 days, = 0.09), estimated blood loss more than 500 ml (13.4% vs 9.3%, = 0.75), and requirement of blood transfusion (10.9% vs 6.2%, = 0.72) were higher in group A.
The application of correct terminology is important to understand the subject and to convey the information. Simple nephrectomy is not an appropriate term as it is equally challenging to perform than its radical counterpart.
“简单”一词意味着“易于完成”或“毫无困难”。因此,“单纯肾切除术”(SN)手术应该“易于实施”。然而,在临床实践中,我们注意到SN手术可能比根治性肾切除术(RN)同样具有挑战性甚至更具挑战性。本研究通过比较各种术中及术后因素,评估修改单纯肾切除术术语的必要性,并确定SN与RN之间的难度水平。
本研究纳入了因良性肾脏疾病接受开放性SN手术的患者(A组)和因T1/2期肾肿瘤接受RN手术的患者(B组)。比较两组的手术时间、估计失血量、术后并发症、输血率和住院时间。
共分析了114例患者(A组82例,B组32例)。B组患者的平均年龄更高(41.2岁对53.6岁,P<0.01)。A组的平均手术时间(136.8分钟对125.5分钟,P = 0.08)、术后并发症发生率(32.9%对25%,P = 0.50)、住院时间(7.2天对6.5天,P = 0.09)、估计失血量超过500毫升的比例(13.4%对9.3%,P = 0.75)以及输血需求(10.9%对6.2%,P = 0.72)均更高。
正确术语的应用对于理解主题和传达信息很重要。单纯肾切除术不是一个合适的术语,因为它的实施难度与根治性肾切除术相当。