Laparoscopic versus open radical nephrectomy for xanthogranulomatous pyelonephritis: Contemporary outcomes analysis

Brian A. Vanderbrink, Michael C. Ost, Ardeshir Rastinehad, Ann Anderson, Gopal H. Badlani, Arthur D. Smith, Michael A. Levine, Benjamin R. Lee

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Background and Purpose: Early experience with laparoscopic nephrectomy for xanthogranulomatous pyelonephritis (XGP) was associated with high conversion and complication rates. We describe our institution's experience with this procedure compared with a contemporary cohort of patients with XGP treated by open nephrectomy. Patients and Methods: Retrospective review of surgical pathology reports from radical nephrectomies at our institution between 1995 and 2005 yielded a diagnosis of XGP in 12 patients, 6 of whom had undergone laparoscopic surgery. Each patient's medical records were reviewed, with intraoperative and postoperative parameters, including complications, being recorded. Results: Transperitoneal laparoscopic nephrectomy was successful in five patients (83%). Hand-assist ports were utilized in two patients because of failure to progress. The operative times were 301 ± 106 minutes and 167 ± 40 minutes in the laparoscopic and open-surgery groups, respectively (P = 0.03). There was no statistical difference with regard to estimated blood loss, transfusion rate, or parenteral analgesic requirements, but there was a trend toward a shorter stay for the laparoscopic group. Complications were noted in three and two patients in the laparoscopic and open-surgery groups, respectively. Conclusions: The outcomes of nephrectomy for XGP were similar regardless of surgical approach. The results in patients with XGP were similar to initial reports in the literature and may be dependent on surgeon experience. We believe that in experienced hands, laparoscopic nephrectomy may be offered to patients with XGP.

Original languageEnglish (US)
Pages (from-to)65-70
Number of pages6
JournalJournal of Endourology
Volume21
Issue number1
DOIs
StatePublished - Jan 1 2007
Externally publishedYes

ASJC Scopus subject areas

  • Urology

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