Laparoscopic Versus Open Nephrectomy : Clinical Effectivness and Cost Analysis

Summary

To evaluate and compare clinical effectiveness (operative time, blood loss, hospital stay, complications and etc) and cost analysis' between laparoscopic nephrectomy and open nephrectomy .

Eligibility

Inclusion Criteria:

* American Society of Anesthesiology score 1-3.
* Indication for :

  * Simple total nephrectomy or hemi nephrectomy: benign chronic inflammatory non-functioning kidney
  * Partial nephrectomy: localized renal mass ≤7 cm suitable for nephron-sparing surgery.
  * Radical nephrectomy or Radical nephrouretrectomy with bladder cuff: localized renal tumor requiring complete nephrectomy without major vascular invasion.
* Patient deemed fit for general anesthesia and surgery.
* Patient provides written informed consent.

Exclusion Criteria:

* emergency surgery, dialysis-dependent patients, planned hybrid procedures.
* Patients with incomplete data
* Patients with metastatic disease at presentation.
* Prior extensive ipsilateral retroperitoneal surgery or severe adhesions precluding Laparoscopy.
* Need for concomitant major procedures (eg, large bowel resection) at index operation.
* Locally advanced tumor with obvious major vascular involvement requiring complex vascular reconstruction.
* Uncorrected coagulopathy.
* Pregnancy or Obese patient (BMI \> 40)
* Inability to provide informed consent or comply with follow-up.

Conditions3

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