NEPHRECTOMY: COMPARATIVE ANALYSIS OF THE SURGICAL OUTCOME BETWEEN THE LAPAROSCOPIC AND OPEN ROUTES IN 74 PATIENTS OPERATED IN A SINGLE INSTITUTION

Summary objective: To analyze the surgical outcome of patients with renal cancer submitted to open and laparoscopic nephrectomy in a specialized cancer hospital in Curitiba. Methods: Retrospective descriptive comparative study. For patients with renal tumors submitted to nephrectomy during the period from Jan-2010 to Nov-2015 at Hospital Erasto Gaertner de Curitiba-PR. In this study, the patients were allocated to the group submitted to open nephrectomy and to the group that performed the minimally invasive procedure. Comparative statistical analyses between the groups were performed by the SPSS 23.0 and STATA 15 programs, p<0.05 being considered statistically significant. Results: The outcomes of 74 patients were analyzed, 16 of which were submitted to laparoscopic nephrectomy, with the remaining 58 submitted to open surgery. The majority of the cases refer to radical nephrectomy, corresponding to 68.80% of the cases of laparoscopic nephrectomy and 81.00% of open nephrectomy. In 21.10% of the cases of open surgeries there were associated adrenalectomies, which did not occur by the laparoscopic route (p = 0.04). The number of Clavien-Dindo grade 3, 4 and 5 postoperative complications was also significantly higher in the open surgery group, occurring in 15.50% of cases, while the group submitted to laparoscopy did not present complications in these grades (p = 0.03). These findings are consistent with those found by other authors, whose results show that patients submitted to minimally invasive surgeries present fewer complications and generally require less RBC transfusion. The postoperative outcome can also be analyzed by evaluating the length of stay in days, which was higher in patients undergoing open surgery (p = 0.02), and the length of stay in the ICU, a resource that was not necessary for patients undergoing laparoscopic nephrectomy (p = 0.01). Conclusions: Our study points out that minimally invasive surgery in renal cancer is associated with fewer severe complications and shorter length of stay in the ward and ICU.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
23 October 2019