Resumen

BALLESTEROS SAMPOL, Juan José. Indications, morbidity and mortality of the open nephrectomy: Analyses of 681 cases and bibliographic review. Arch. Esp. Urol. [online]. 2006, vol.59, n.1, pp.59-70. ISSN 0004-0614.

Objectives: To have data about theindications, morbidity and mortality of the nephrectomy by the open approach, to obtain information that could be compared with the laparoscopic approach. To our knowledge there is not a similar review in the Spanish literature since this 60’s. Methods: We analyzed 681 nephrectomies accounting for a 5.7% of a total of 11.845 operative reportsregistered in our centre over the last 25 years. For outcome analysis, 93 cadaver donor nephrectomies were excluded. The analysis focuses on three well differentiated areas: kidney transplant surgery, nephrectomies for malignant diseases, and nephrectomies for benign pathologiesincluding a very specific subgroup that includes theinfectious-inflammatory diseases. In parallel, we performed a bibliographic review in which more than 87,000 cases of open surgeries where referenced, adding the articles about laparoscopic nephrectomies published over the last decade. Results: Global mortality of the series (the first 30postoperative days) was 0.8%, mostly cases of transplant nephrectomies (4), and one upper urinary tract transitional cell carcinoma. Significant morbidity appeared in 47 cases (8%), 15 of which (2.5%) required reoperation, being intensive bleeding with hypovolemia of variable severity the most frequent cause.The series includes non selected cases of a wide spectrum of pathologies. Any comparison with minimally invasive approaches should take into consideration, among other parameters, selection of the cases.

Palabras clave : Open surgery; Open nephrectomy; Laparoscopic nephrectomy; Complications.

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