Laparoscopic Versus Open Nephrectomy : Clinical Effectivness and Cost Analysis

Laparoscopic Versus Open Nephrectomy : Clinical Effectivness and Cost Analysis

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

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.