Martinez-Esteban Alejandro, Barron-Cervantes Natalia M, Fuentes-Calvo Kevin J, Arechavala-Lopez Sara F, Ramos-Carpinteyro Roxana, Cendejas-Gomez J Jesus, Méndez-Probst Carlos E
General and Gastrointestinal Surgery Service, Fundacion Clinica Medica Sur, Mexico City, MEX.
Urology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MEX.
Cureus. 2024 Aug 29;16(8):e68142. doi: 10.7759/cureus.68142. eCollection 2024 Aug.
To assess the efficacy and safety of simple open versus laparoscopic nephrectomies for treating benign renal pathologies, with a focus on comparing the prevalence of surgical complications at a first-level center in Mexico City.
A retrospective analysis spanning 2010-2020 was conducted where all patients undergoing simple nephrectomy for benign conditions were included and stratified into open and laparoscopic surgery groups. Variables analyzed included urological history, laboratory findings, surgical outcomes, complications, and histopathological results. Statistical comparisons employed Student's t-test for means and the chi-square test for frequencies. Additionally, binary logistic regression was utilized to identify predictors associated with conversion from laparoscopic to open surgery.
The laparoscopic approach showed significant advantages in intraoperative bleeding (p=0.008) and intensive care unit stay (p=0.04). The conversion rate from laparoscopic to open surgery was 19.23%, with no significant risk factors identified for conversion.
Laparoscopic simple nephrectomy proves to be a secure and effective method in specialized urological centers with skilled surgeons, offering superior intraoperative outcomes compared to open surgery. It effectively reduces intraoperative hemorrhage, minimizes blood transfusion needs, and shortens hospital stays. Nonetheless, challenges such as equipment availability, costs, and surgeon expertise must be addressed. Further research focused on postoperative complications is crucial to advocate for broader adoption of laparoscopic nephrectomy as the preferred standard for treating relevant urological conditions, emphasizing substantial advantages over traditional open approaches.
评估单纯开放性肾切除术与腹腔镜肾切除术治疗良性肾脏疾病的疗效和安全性，重点比较墨西哥城一家一级中心的手术并发症发生率。
对2010年至2020年进行回顾性分析，纳入所有因良性疾病接受单纯肾切除术的患者，并分为开放手术组和腹腔镜手术组。分析的变量包括泌尿系统病史、实验室检查结果、手术结果、并发症和组织病理学结果。统计比较采用均值的学生t检验和频率的卡方检验。此外，采用二元逻辑回归来确定与腹腔镜手术转为开放手术相关的预测因素。
腹腔镜手术在术中出血（p=0.008）和重症监护病房停留时间（p=0.04）方面显示出显著优势。腹腔镜手术转为开放手术的转化率为19.23%，未发现转为开放手术的显著危险因素。
在有经验丰富外科医生的专业泌尿外科中心，腹腔镜单纯肾切除术被证明是一种安全有效的方法，与开放手术相比，术中效果更佳。它有效减少术中出血，最大限度减少输血需求，并缩短住院时间。尽管如此，设备可用性、成本和外科医生专业知识等挑战必须得到解决。专注于术后并发症的进一步研究对于倡导更广泛地采用腹腔镜肾切除术作为治疗相关泌尿系统疾病的首选标准至关重要，强调其相对于传统开放手术方法的显著优势。
