Transperitoneal Laparoscopic Radical Nephrectomy for Patients With Dialysis-dependent End-stage Renal Disease: An Analysis and Comparison of Perioperative Outcome

Objectives To evaluate LRN as treatment for high risk patients. Laparoscopic radical nephrectomy (LRN) is performed for renal tumors not amenable to nephron-sparing treatments. Indications are increasing to include higher risk patients including those with end-stage renal disease (ESRD) necessitatin...

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Veröffentlicht in:	Urology (Ridgewood, N.J.) N.J.), 2010-06, Vol.75 (6), p.1335-1342
Hauptverfasser:	Bird, Vincent G, Shields, John M, Aziz, Mohammed, De Los Santos, Rosely, Ayyathurai, Rajnikanth, Ciancio, Gactano
Format:	Artikel
Sprache:	eng
Schlagworte:	Aged Biological and medical sciences Case-Control Studies Cohort Studies Female Follow-Up Studies Hospital Mortality - trends Humans Kidney Failure, Chronic - complications Kidney Failure, Chronic - diagnosis Kidney Failure, Chronic - therapy Kidney Neoplasms - complications Kidney Neoplasms - pathology Kidney Neoplasms - surgery Laparoscopy - methods Laparoscopy - mortality Male Medical sciences Middle Aged Minimally Invasive Surgical Procedures - methods Minimally Invasive Surgical Procedures - mortality Neoplasm Staging Nephrectomy - methods Nephrectomy - mortality Nephrology. Urinary tract diseases Nephrons - surgery Nephropathies. Renovascular diseases. Renal failure Peritoneum - surgery Postoperative Complications - diagnosis Postoperative Complications - mortality Probability Reference Values Renal Dialysis - adverse effects Renal Dialysis - methods Renal failure Retrospective Studies Risk Assessment Severity of Illness Index Survival Rate Treatment Outcome Urology
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Zusammenfassung:	Objectives To evaluate LRN as treatment for high risk patients. Laparoscopic radical nephrectomy (LRN) is performed for renal tumors not amenable to nephron-sparing treatments. Indications are increasing to include higher risk patients including those with end-stage renal disease (ESRD) necessitating dialysis. Methods We performed a retrospective analysis of a patient cohort with clinical stage T1 renal tumors undergoing transperitoneal LRN. Parameters examined included patient demographics, medical comorbidities, tumor characteristics, operative outcomes, and complications. Results One hundred eighty-nine patients underwent 195 LRN. Sixteen patients (8.5%) had preexistent ESRD requiring dialysis. A higher American Society of Anesthiologists score ( P
ISSN:	0090-4295 1527-9995
DOI:	10.1016/j.urology.2009.10.030