Laparoscopic and open surgical nephrectomy for xanthogranulomatous pyelonephritis

Herkanwal S. Khaira, Rajal B. Shah, J. Stuart Wolf

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background and Purpose: Xanihogramilomatous pyelonephritis (XGP) is a severe, chronic renal-parenchymal infection. Nephrectomy is the treatment of choice. Because of the renal and perirenal inflammatory changes that commonly accompany XGP, the laparoscopic approach is difficult. We compared our experience with laparoscopic and open surgical nephrectomy for XGP. Patients and Methods: A retrospective chart review of all adult nephrectomy specimens with the pathologic diagnosis of XGP between January 1997 and May 2003 was performed. Preoperative presentation, operative details, and postoperative recovery and complications were included in the data collection. Results: Three patients approached laparoscopically and eight patients approached with open surgery were found to have XGP on pathologic analysis. The disease was suspected preoperatively in all patients. Among the laparoscopically treated patients, there was 1 (33%) who suffered major complications; this was the only patient who required conversion to open surgery. Among the open-surgical group, there were 2 (22%) major and 3 (33%) minor complications. Postoperative hospitalization was longer in the open-surgical group (mean 13.7 v 4.7 days), and when the case of open conversion was excluded, narcotic use was less in the laparoscopy group. Conclusions: The treatment of some XGP cases with laparoscopic nephrectomy is a possible, albeit challenging, option. The incidences of intraoperative and postoperative complications were roughly equivalent in the laparoscopic and open-surgery patients in our study. If completed, laparoscopy appears to be associated with decreased postoperative morbidity. However, this may represent selection bias, and larger, prospective studies may better define the suspected benefit.

Original languageEnglish (US)
Pages (from-to)813-817
Number of pages5
JournalJournal of Endourology
Volume19
Issue number7
DOIs
StatePublished - Sep 1 2005
Externally publishedYes

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Xanthogranulomatous Pyelonephritis
Nephrectomy
Pyelonephritis
Laparoscopy
Conversion to Open Surgery
Kidney
Selection Bias
Narcotics
Intraoperative Complications
Hospitalization
Prospective Studies
Morbidity
Incidence

ASJC Scopus subject areas

  • Urology

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Laparoscopic and open surgical nephrectomy for xanthogranulomatous pyelonephritis. / Khaira, Herkanwal S.; Shah, Rajal B.; Wolf, J. Stuart.

In: Journal of Endourology, Vol. 19, No. 7, 01.09.2005, p. 813-817.

Research output: Contribution to journalArticle

Khaira, Herkanwal S. ; Shah, Rajal B. ; Wolf, J. Stuart. / Laparoscopic and open surgical nephrectomy for xanthogranulomatous pyelonephritis. In: Journal of Endourology. 2005 ; Vol. 19, No. 7. pp. 813-817.
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