Comparative Study between Open and Laparoscopic Nephrectomy

Abstract

 Introduction: This is an era of minimal invasive surgery. There are various modalities of nephrectomy for removing non-functioning kidney. The aim of this study is to compare outcome following open and laparoscopic nephrectomy in context to operative duration, post-operative pain, complication and quality of life.

Methods: This is a retro-prospective clinical study in 40 patients with non-functioning kidney. Previous patients who have undergone open nephrectomy were compared with new patients who underwent laparoscopic nephrectomy in this study.

Results: There was no difference in age, gender and side of lesion in both groups. There was significantly prolonged operative duration in laparoscopic nephrectomy (177.75±20.68 min vs 150±13.28 min, p=0.008). Significantly high pain score in open group (7.1±0.31 vs 4.05±0.76, p<0.001) was observed. There was prolonged hospital stay in open group than in laparoscopic group which is statistically significant (6.30±0.66 days vs 3.10±0.72 days, p<0.001). There was early return to normal work in laparoscopic group (13.45±2.19 days vs 27.05±1.99 days, p<0.001). There was more post-operative complication observed in open group (65%); all were surgical site infections which is statistically significant (p<0.001).

Conclusion: Laparoscopic nephrectomy is better than open in terms of post-operative pain, hospital stay, post-operative complication and return to normal work, though the operative duration is significantly prolonged than open nephrectomy.