Laparoscopis nephrectomy for atrophic kidney with serious infectious episode

Czech version

Authors: H. Yanaihara
Published in: Urol List 2013; 11(1): 23-26

Overview

Recently, laparoscopic procedures are applied to any surgical situations with the improvement of techniques and devices. However, laparoscopic nephrectomy for atrophic kidney with serious infectious episode is still a challenging procedure with high rate of open conversion and blood transfusion because of unpredictable perinephric inflammatory change. Unfortunately this procedure is not common in daily practice. Therefore, there are only a few reports of nephrectomy itself, and futhermore the standard management of the patient has never been summarized. First of all, key step would start from the control of infection. The choice of nephrectomy or ureteral stent would not be a matter. The patient would be better to spend a month daily life after complete remission of infection before nephrectomy. Transperitoneal approach is personally recommended but retropeitoneal approach can be chosen for certain cases. Surgical procedure should be done meticulously more than usual and sometimes brave decision could be required to find break-through. Once all procedure has been accomplished, postoperative course is usually favorable. Laparoscopic nephrectomy for atrophic kidney with serious infectious episode may be difficult. However, reported operation time is comparable to laparoscopic radical nephrectomy. This procedure could be the first choice for the experienced surgeon and should be always included in the choice for any surgeons.

Key words:
laparoscopic nephrectomy, atrophic kidney, infection

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