Objectives: 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. © 2012 CLINICS.678907909Korkes, F., Favoretto, R.L., Bróglio, M., Silva, C.A., Castro, M.G., Perez, M.D., Xanthogranulomatous pyelonephritis: Clinical experience with 41 cases (2008) Urology, 71 (2), pp. 178-180. , http://dx.doi.org/10.1016/j.urology.2007.09.026Petronic, V., Buturovic, J., Isvaneski, M., Xanthogranulomatous pyelonephritis (1989) Br J Urol, 64 (4), pp. 336-338. , http://dx.doi.org/10.1111/j.1464-410X.1989.tb06036.xBercowsky, E., Shalhav, A.L., Portis, A., Elbahnasy, A.M., McDougall, E.M., Clayman, R.V., Is the laparoscopic approach justified in patients with xanthogranulomatous pyelonephritis? (1999) Urology, 54 (3), pp. 437-442. , http://dx.doi.org/10.1016/S0090-4295(99)00261-7Rosoff, J.S., Raman, J.D., Del Pizzo, J.J., Feasibility of laparoscopic approach in management of xanthogranulomatous pyelonephritis (2006) Urology, 68 (4), pp. 711-714. , http://dx.doi.org/10.1016/j.urology.2006.04.031Kapoor, R., Vijjan, V., Singh, K., Goyal, R., Mandhani, A., Dubey, D., Is laparoscopic nephrectomy the preferred approach in xanthogranulomatous pyelonephritis? (2006) Urology, 68 (5), pp. 952-955. , http://dx.doi.org/10.1016/j.urology.2006.07.009Manohar, T., Desai, M., Desai, M., Laparoscopic nephrectomy for benign and inflammatory conditions (2007) J Endourol, 21 (11), pp. 1323-1328. , http://dx.doi.org/10.1089/end.2007.9883Tunc, L., Biri, H., Onaran, M., Krac, M., Yesil, S., Bozkirli, I., Laparoscopic nephrectomy for xanthogranulomatous pyelonephritis in the absence of kidney stones or clinical urinary infection (2007) Surg Laparosc Endosc Percutan Tech, 17 (6), pp. 570-572. , http://dx.doi.org/10.1097/SLE.0b013e31812e5360Duarte, R.J., Mitre, A.I., Chambô, J.L., Arap, M.A., Srougi, M., Laparoscopic nephrectomy outside gerota fascia for management of inflammatory kidney (2008) J Endourol, 22 (4), pp. 681-686. , http://dx.doi.org/10.1089/end.2007.0291Rogers, C., Laungani, R., Krane, L.S., Bhandari, A., Bhandari, M., Menon, M., Robotic nephrectomy for the treatment of benign and malignant disease (2008) BJU Int, 102 (11), pp. 1660-1665. , http://dx.doi.org/10.1111/j.1464-410X.2008.07895.xGuzzo, T.J., Bivalacqua, T.J., Pierorazio, P.M., Varkarakis, J., Schaeffer, E.M., Allaf, M.E., Xanthogranulomatous pyelonephritis: Presentation and management in the era of laparoscopy (2009) BJU Int, 104 (9), pp. 1265-1268. , http://dx.doi.org/10.1111/j.1464-410X.2009.08547.xDindo, D., Demartines, N., Clavien, P.A., Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey (2004) Ann Surg, 240 (2), pp. 205-213. , http://dx.doi.org/10.1097/01.sla.0000133083.54934.ae