Comparative study of morbidity and mortality pre- and postoperative of laparoscopic nephrectomy for inflammatory versus tumoral cause according to the Clavien–Dindo classification: prospective study over 2 years

Abstract

Background: For 29 years, Laparoscopic Nephrectomy has steadily established itself as a technique for kidney excision. Patients as well as surgeons appreciate the benefits of this less invasive technique. Although the morbidity and mortality of this minimally invasive technique are relatively low, the risks it entails must be taken into account seriously. The purpose of this study is to evaluate and compare the intra- and postoperative morbidity and mortality factors connected to Laparoscopic Transperitoneal Nephrectomy for inflammatory kidney versus tumoral kidney according to the Clavien–Dindo classification. Methods: A prospective comparative mono-centric study was carried out over a period of 24 months (January 2018–January 2020) on patients having benefited from a Laparoscopic Transperitoneal Nephrectomy for Inflammatory (Group 1) or Tumoral (Group 2) causes. Postoperative morbidity and mortality were assessed according to the Dindo–Clavien classification. Results: This study included 60 patients. Group 1 consisted of 32 patients (median age: 50.4 years) and Group 2 of 28 patients (median age: 61 years). Drainage of inflammatory kidneys was done preoperatively by nephrostomy drain (11 cases) and double J probe (3 cases). The mean operating time was longer in Group 1 (234 vs 186.8 min, p = 0.1). The conversion rate was statistically significant in Group 1 (6 vs 1, p < 0.05). The rate of Grade 1 complications is very significant in Group 1: ileus (6 vs 2, p = 0.02), postoperative antibiotic therapy (26 vs 3, p = 0.001) and infection of the wall (4 vs 0, p < 0.001). The rate of severe complications (Clavien ≥ 3) was the same in the two groups. The average length of hospital stay was higher in Group1. Conclusion: Our work (study) showed a higher rate of severe complications in Laparoscopic nephrectomies for inflammatory causes.