Major complications in 213 laparoscopic nephrectomy cases: The Indianapolis experience

Tibério M. Siqueira, Ramsay L. Kuo, Thomas Gardner, Ryan F. Paterson, Larry H. Stevens, James E. Lingeman, Michael Koch, Arieh L. Shalhav

Research output: Contribution to journalArticle

89 Citations (Scopus)

Abstract

Purpose: We assessed the incidence of and analyzed factors that may help prevent major complications and open conversion during laparoscopic nephrectomy at our institutions. Materials and Methods: We retrospectively analyzed all laparoscopic nephrectomies performed between August 1, 1999 and July 31, 2001. Data were stratified for nephrectomy type, intraoperative and postoperative complications. Conversion to open surgery was stratified for emergency versus elective procedures. Results: Of the 292 laparoscopic procedures performed at our institutions in 2 years 213 (73%) involved laparoscopic nephrectomy, including 84 live donor nephrectomies, 61 radical nephrectomies, 55 simple nephrectomies and 13 nephroureterectomies. A total of 16 major complications (7.5%) occurred, including access related, intraoperative and postoperative complications in 3, 9 and 4 cases, respectively. The conversion rate was 6.1% (13 patients), the transfusion rate was 1.9% and the mortality rate was 0.5% (1 death). Only 1 complication was related to simple laparoscopic nephrectomy, although this group showed the highest rate of elective conversion (7 of 8 elective conversions). Laparoscopic live donor nephrectomy showed the highest rate for emergency conversion (3 of 5 emergency conversions). Conclusions: Our results reinforce the importance of thorough preoperative imaging, careful patient selection, surgeon experience and skill maintenance in laparoscopy as well as a low threshold for conversion to open surgery. This series provides additional evidence to support the evolution of laparoscopic nephrectomy into a standard of care.

Original languageEnglish
Pages (from-to)1361-1365
Number of pages5
JournalJournal of Urology
Volume168
Issue number4 I
StatePublished - Oct 2002

Fingerprint

Nephrectomy
Conversion to Open Surgery
Emergencies
Intraoperative Complications
Tissue Donors
Standard of Care
Laparoscopy
Patient Selection
Maintenance
Mortality
Incidence

Keywords

  • Intraoperative complications
  • Kidney
  • Laparoscopy
  • Nephrectomy
  • Postoperative complications

ASJC Scopus subject areas

  • Urology

Cite this

Siqueira, T. M., Kuo, R. L., Gardner, T., Paterson, R. F., Stevens, L. H., Lingeman, J. E., ... Shalhav, A. L. (2002). Major complications in 213 laparoscopic nephrectomy cases: The Indianapolis experience. Journal of Urology, 168(4 I), 1361-1365.

Major complications in 213 laparoscopic nephrectomy cases : The Indianapolis experience. / Siqueira, Tibério M.; Kuo, Ramsay L.; Gardner, Thomas; Paterson, Ryan F.; Stevens, Larry H.; Lingeman, James E.; Koch, Michael; Shalhav, Arieh L.

In: Journal of Urology, Vol. 168, No. 4 I, 10.2002, p. 1361-1365.

Research output: Contribution to journalArticle

Siqueira, TM, Kuo, RL, Gardner, T, Paterson, RF, Stevens, LH, Lingeman, JE, Koch, M & Shalhav, AL 2002, 'Major complications in 213 laparoscopic nephrectomy cases: The Indianapolis experience', Journal of Urology, vol. 168, no. 4 I, pp. 1361-1365.
Siqueira TM, Kuo RL, Gardner T, Paterson RF, Stevens LH, Lingeman JE et al. Major complications in 213 laparoscopic nephrectomy cases: The Indianapolis experience. Journal of Urology. 2002 Oct;168(4 I):1361-1365.
Siqueira, Tibério M. ; Kuo, Ramsay L. ; Gardner, Thomas ; Paterson, Ryan F. ; Stevens, Larry H. ; Lingeman, James E. ; Koch, Michael ; Shalhav, Arieh L. / Major complications in 213 laparoscopic nephrectomy cases : The Indianapolis experience. In: Journal of Urology. 2002 ; Vol. 168, No. 4 I. pp. 1361-1365.
@article{bf8eb91581c248c9b275b951171343be,
title = "Major complications in 213 laparoscopic nephrectomy cases: The Indianapolis experience",
abstract = "Purpose: We assessed the incidence of and analyzed factors that may help prevent major complications and open conversion during laparoscopic nephrectomy at our institutions. Materials and Methods: We retrospectively analyzed all laparoscopic nephrectomies performed between August 1, 1999 and July 31, 2001. Data were stratified for nephrectomy type, intraoperative and postoperative complications. Conversion to open surgery was stratified for emergency versus elective procedures. Results: Of the 292 laparoscopic procedures performed at our institutions in 2 years 213 (73{\%}) involved laparoscopic nephrectomy, including 84 live donor nephrectomies, 61 radical nephrectomies, 55 simple nephrectomies and 13 nephroureterectomies. A total of 16 major complications (7.5{\%}) occurred, including access related, intraoperative and postoperative complications in 3, 9 and 4 cases, respectively. The conversion rate was 6.1{\%} (13 patients), the transfusion rate was 1.9{\%} and the mortality rate was 0.5{\%} (1 death). Only 1 complication was related to simple laparoscopic nephrectomy, although this group showed the highest rate of elective conversion (7 of 8 elective conversions). Laparoscopic live donor nephrectomy showed the highest rate for emergency conversion (3 of 5 emergency conversions). Conclusions: Our results reinforce the importance of thorough preoperative imaging, careful patient selection, surgeon experience and skill maintenance in laparoscopy as well as a low threshold for conversion to open surgery. This series provides additional evidence to support the evolution of laparoscopic nephrectomy into a standard of care.",
keywords = "Intraoperative complications, Kidney, Laparoscopy, Nephrectomy, Postoperative complications",
author = "Siqueira, {Tib{\'e}rio M.} and Kuo, {Ramsay L.} and Thomas Gardner and Paterson, {Ryan F.} and Stevens, {Larry H.} and Lingeman, {James E.} and Michael Koch and Shalhav, {Arieh L.}",
year = "2002",
month = "10",
language = "English",
volume = "168",
pages = "1361--1365",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "4 I",

}

TY - JOUR

T1 - Major complications in 213 laparoscopic nephrectomy cases

T2 - The Indianapolis experience

AU - Siqueira, Tibério M.

AU - Kuo, Ramsay L.

AU - Gardner, Thomas

AU - Paterson, Ryan F.

AU - Stevens, Larry H.

AU - Lingeman, James E.

AU - Koch, Michael

AU - Shalhav, Arieh L.

PY - 2002/10

Y1 - 2002/10

N2 - Purpose: We assessed the incidence of and analyzed factors that may help prevent major complications and open conversion during laparoscopic nephrectomy at our institutions. Materials and Methods: We retrospectively analyzed all laparoscopic nephrectomies performed between August 1, 1999 and July 31, 2001. Data were stratified for nephrectomy type, intraoperative and postoperative complications. Conversion to open surgery was stratified for emergency versus elective procedures. Results: Of the 292 laparoscopic procedures performed at our institutions in 2 years 213 (73%) involved laparoscopic nephrectomy, including 84 live donor nephrectomies, 61 radical nephrectomies, 55 simple nephrectomies and 13 nephroureterectomies. A total of 16 major complications (7.5%) occurred, including access related, intraoperative and postoperative complications in 3, 9 and 4 cases, respectively. The conversion rate was 6.1% (13 patients), the transfusion rate was 1.9% and the mortality rate was 0.5% (1 death). Only 1 complication was related to simple laparoscopic nephrectomy, although this group showed the highest rate of elective conversion (7 of 8 elective conversions). Laparoscopic live donor nephrectomy showed the highest rate for emergency conversion (3 of 5 emergency conversions). Conclusions: Our results reinforce the importance of thorough preoperative imaging, careful patient selection, surgeon experience and skill maintenance in laparoscopy as well as a low threshold for conversion to open surgery. This series provides additional evidence to support the evolution of laparoscopic nephrectomy into a standard of care.

AB - Purpose: We assessed the incidence of and analyzed factors that may help prevent major complications and open conversion during laparoscopic nephrectomy at our institutions. Materials and Methods: We retrospectively analyzed all laparoscopic nephrectomies performed between August 1, 1999 and July 31, 2001. Data were stratified for nephrectomy type, intraoperative and postoperative complications. Conversion to open surgery was stratified for emergency versus elective procedures. Results: Of the 292 laparoscopic procedures performed at our institutions in 2 years 213 (73%) involved laparoscopic nephrectomy, including 84 live donor nephrectomies, 61 radical nephrectomies, 55 simple nephrectomies and 13 nephroureterectomies. A total of 16 major complications (7.5%) occurred, including access related, intraoperative and postoperative complications in 3, 9 and 4 cases, respectively. The conversion rate was 6.1% (13 patients), the transfusion rate was 1.9% and the mortality rate was 0.5% (1 death). Only 1 complication was related to simple laparoscopic nephrectomy, although this group showed the highest rate of elective conversion (7 of 8 elective conversions). Laparoscopic live donor nephrectomy showed the highest rate for emergency conversion (3 of 5 emergency conversions). Conclusions: Our results reinforce the importance of thorough preoperative imaging, careful patient selection, surgeon experience and skill maintenance in laparoscopy as well as a low threshold for conversion to open surgery. This series provides additional evidence to support the evolution of laparoscopic nephrectomy into a standard of care.

KW - Intraoperative complications

KW - Kidney

KW - Laparoscopy

KW - Nephrectomy

KW - Postoperative complications

UR - http://www.scopus.com/inward/record.url?scp=0036783946&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036783946&partnerID=8YFLogxK

M3 - Article

C2 - 12352393

AN - SCOPUS:0036783946

VL - 168

SP - 1361

EP - 1365

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 4 I

ER -