dc.creatorLima, Marcelo
dc.creatorMiyaoka, Ricardo
dc.creatorMoro, Juliano
dc.creatorD'Ancona, Carlos
dc.date2012-08-01
dc.date2014-07-18T18:04:23Z
dc.date2015-11-26T11:37:58Z
dc.date2014-07-18T18:04:23Z
dc.date2015-11-26T11:37:58Z
dc.date.accessioned2018-03-28T20:41:24Z
dc.date.available2018-03-28T20:41:24Z
dc.identifierClinics. Faculdade de Medicina / USP, v. 67, n. 8, p. 907-909, 2012.
dc.identifier1807-5932
dc.identifierS1807-59322012000800009
dc.identifier10.6061/clinics/2012(08)09
dc.identifierhttp://dx.doi.org/10.6061/clinics/2012(08)09
dc.identifierhttp://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322012000800009
dc.identifierhttp://www.repositorio.unicamp.br/jspui/handle/REPOSIP/35386
dc.identifierhttp://repositorio.unicamp.br/jspui/handle/REPOSIP/35386
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/1233847
dc.descriptionOBJECTIVES: Laparoscopic nephrectomy for xanthogranulomatous pyelonephritis is currently associated with great operative difficulty and surgical complications. Herein, we report on our single-center experience and describe predictive factors for successfully accomplishing this procedure. METHOD: Between March 1998 and April 2010, 66 patients (27 men and 39 women) underwent laparoscopic nephrectomy for the treatment of a unilateral nonfunctioning kidney. These patients had previous diagnoses of renal chronic inflammation associated with calculi and previous pyonephrosis. All of the nephrectomies were performed using the transperitoneal approach, and a similar technique was used for radical nephrectomy. RESULTS: Laparoscopic nephrectomy for the treatment of renal chronic inflammation was successful in 58/66 cases (87.9%). Eight cases were converted to the open technique because of difficulty in progression, which was related to the discovery of dense adhesions in the hilar or perirenal region. One major (colonic lesion) and two minor (wound infection) complications occurred in the conversion group. A diagnosis of xanthogranulomatous pyelonephritis was confirmed pathologically for all of the specimens. Of the factors examined, a longitudinal renal length greater than 12 cm (laparoscopy group - 7.2±1.8 cm, versus open group - 13.6±1.5 cm; p<0.05) and time to access the renal vessels (laparoscopy group - 32±18 min, versus open group - 91±11 min; p<0.05) were associated with a higher conversion rate. Although the number of patients in the conversion group was small, the majority of these patients received right-sided nephrectomy. CONCLUSIONS: Laparoscopic nephrectomy for the treatment of xanthogranulomatous pyelonephritis is feasible and associated with low levels of morbidity. Factors including the time required to control the renal vessels, renal length and right-sided nephrectomy were associated with higher chances of conversion into an open procedure.
dc.description907
dc.description909
dc.languageen
dc.publisherFaculdade de Medicina / USP
dc.relationClinics
dc.rightsaberto
dc.sourceSciELO
dc.subjectXanthogranulomatous Pyelonephritis
dc.subjectLaparoscopic Nephrectomy
dc.subjectComplications
dc.subjectTreatment
dc.titleLaparoscopic nephrectomy for xanthogranulomatous pyelonephritis: are there predictive factors for success?
dc.typeArtículos de revistas


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