Open Versus Laparoscopic Nephrectomy: A Comparative Study in Prince Hussein Urology Center
Ashraf Suleiman AL-Majali *
Prince Hussein Urology Center, Jordanian Royal Medical Services, Amman, Jordan.
Awad Bakheet AL-Kaabneh
Prince Hussein Urology Center, Jordanian Royal Medical Services, Amman, Jordan.
Belal Abdullah Alkhawaldah
Prince Hussein Urology Center, Jordanian Royal Medical Services, Amman, Jordan.
Mohammad Nedal Al-Ajlouni
Department of General Surgery, King Hussien Medical Center, Jordanian Royal Medical Services, Amman, Jordan.
Muhammad Ahmad Rawashdeh
Prince Hussein Urology Center, Jordanian Royal Medical Services, Amman, Jordan.
Mohammad Faisal Mousa
Prince Hussein Urology Center, Jordanian Royal Medical Services, Amman, Jordan.
Balal Abdulnabi Abunaja
Prince Hussein Urology Center, Jordanian Royal Medical Services, Amman, Jordan.
Tareq Ghaleb Alnasser
Prince Hussein Urology Center, Jordanian Royal Medical Services, Amman, Jordan.
Mu’tasem Hasan Alsmadi
Prince Hussein Urology Center, Jordanian Royal Medical Services, Amman, Jordan.
Jihad Refat Asaad
Prince Hussein Urology Center, Jordanian Royal Medical Services, Amman, Jordan.
Bassam Mohammad Aldeikeh
Prince Hussein Urology Center, Jordanian Royal Medical Services, Amman, Jordan.
Mohammad Aref AlFrokh
Prince Hussein Urology Center, Jordanian Royal Medical Services, Amman, Jordan.
Mohammad Zaid Suleiman Al-Abbadi
Prince Hussein Urology Center, Jordanian Royal Medical Services, Amman, Jordan.
Ruba Abdelmajeed Al-Smadi
Department of Pathology, Prince Eman Laboratory Center, Jordanian Royal Medical Services, Amman, Jordan.
Osama Awad AL-Kaabneh
Faculty of Medicine, Jordan University, Amman, Jordan.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Nephrectomy is indicated in benign and malignant renal conditions. The nephrectomy can be performed through open or laparoscopic approach. Open nephrectomy mostly can accomplish by retroperitoneal method but in some cases transperitoneal approach is mandated (bilateral nephrectomy, locally advanced tumor with invasion to the adjacent structures, and severe traumatic renal injury).
Aim: The present study compared the two approaches of nephrectomy regarding the outcomes in Prince Hussein Urology Center.
Methods: Retrospectively 300 patients who underwent nephrectomies between August 2016 and July 2023 in Prince Hussein Urology Center were enrolled in this research. 150 patients had open nephrectomy (group1), and 150 patients had laparoscopic nephrectomy (group2). Comparative data: operative time, hospital stay days, postoperative recovery state, early return to work, and perioperative complications (hemorrhage, organ damage, infection, incisional hernia, and reoperation). The follow-up period was for 1 year.
Results: The patients’ ages were between (21 and 79 years). No significant differences between both groups regarding the demographic data and in some categorical data (operative time, and operative complications), but there were significant differences regarding the postoperative recovery state, early return to work, and occurrence of incisional hernia in favour of laparoscopic nephrectomy. Postoperative recovery was earlier in group 2 (P < 0.05). Mean operative time, and mean hospitalization length was shorter in group 2 (P = 0.0001), respectively. Operative complications were equal in both groups (P > 0.05). Incisional hernia occurred in 7 patients in group 1 and in one case in group2 (P = 0.029). In spite of the comparable surgical oncologic, and functional outcomes, some literatures advised for further quality studies to evaluate the effectiveness of laparoscopic partial nephrectomy and its postoperative quality of life compared with open partial nephrectomy.
Conclusion: The laparoscopic nephrectomy when indicated is superior to open approach because of the lower occurrence of incisional hernia, early postoperative recovery, decreased hospital stay length and early normal activity return. Which overall decreases the cost of nephrectomy surgery.
Keywords: Simple nephrectomy, radical nephrectomy, laparoscopic trans peritoneal nephrectomy, open retroperitoneal nephrectomy