PMID- 10475350
OWN - NLM
STAT- MEDLINE
DCOM- 19991004
LR  - 20190714
IS  - 1527-9995 (Electronic)
IS  - 0090-4295 (Linking)
VI  - 54
IP  - 3
DP  - 1999 Sep
TI  - Is the laparoscopic approach justified in patients with xanthogranulomatous 
      pyelonephritis?
PG  - 437-42; discussion 442-3
AB  - OBJECTIVES: Xanthogranulomatous pyelonephritis (XGP) is an atypical form of 
      chronic renal infection. The treatment of choice is open nephrectomy, which is 
      challenging, given the extent of the disease and the not uncommon involvement of 
      the renal hilum and contiguous structures. We compared our experience with 
      laparoscopic nephrectomy for histologically confirmed XGP with the open approach. 
      METHODS: Review of all nephrectomy specimens at Washington University School of 
      Medicine from July 1990 to March 1998 disclosed 9 patients with a pathologic 
      diagnosis of unilateral XGP, of whom 5 patients underwent laparoscopic 
      nephrectomy and 4 underwent open nephrectomy. XGP was suspected preoperatively in 
      56% of the patients. RESULTS: For the laparoscopic group, the average operating 
      room time was 360 minutes, average blood loss was 260 mL, and complications 
      occurred in 60% of patients (1 conversion to open, 1 ileus, 1 pulmonary embolus). 
      For the open group, the average operating room time was 154 minutes, average 
      blood loss was 438 mL, and there were no complications. Both groups were similar 
      regarding time to oral intake, analgesia requirement, hospital stay, and time to 
      complete recovery. CONCLUSIONS: Our early experience demonstrates that the 
      benefits of laparoscopic nephrectomy, at present, do not extend to patients with 
      XGP. Conventional open surgery is quicker, associated with fewer complications, 
      and results in a similar use of analgesics, hospital stay, and recovery time.
FAU - Bercowsky, E
AU  - Bercowsky E
AD  - Division of Urology, Washington University School of Medicine, Saint Louis, 
      Missouri 63108, USA.
FAU - Shalhav, A L
AU  - Shalhav AL
FAU - Portis, A
AU  - Portis A
FAU - Elbahnasy, A M
AU  - Elbahnasy AM
FAU - McDougall, E M
AU  - McDougall EM
FAU - Clayman, R V
AU  - Clayman RV
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Urology
JT  - Urology
JID - 0366151
SB  - IM
MH  - Aged
MH  - Female
MH  - Humans
MH  - *Laparoscopy
MH  - Male
MH  - Nephrectomy/*methods
MH  - Postoperative Complications/epidemiology
MH  - Pyelonephritis, Xanthogranulomatous/*surgery
EDAT- 1999/09/04 00:00
MHDA- 1999/09/04 00:01
CRDT- 1999/09/04 00:00
PHST- 1999/09/04 00:00 [pubmed]
PHST- 1999/09/04 00:01 [medline]
PHST- 1999/09/04 00:00 [entrez]
AID - S0090-4295(99)00261-7 [pii]
AID - 10.1016/s0090-4295(99)00261-7 [doi]
PST - ppublish
SO  - Urology. 1999 Sep;54(3):437-42; discussion 442-3. doi: 
      10.1016/s0090-4295(99)00261-7.