HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Nephrectomy for benign disease in the UK: results from the British Association of Urological Surgeons nephrectomy database.

AbstractOBJECTIVE:
To summarize the practice of UK urologists with regard to nephrectomy for benign disease, documenting the indications, procedural techniques and outcomes.
METHODS:
All patients undergoing nephrectomy for a benign condition in 2012 were identified from the British Association of Urological Surgeons (BAUS) nephrectomy database. Recorded variables included the technique of surgery, the type of minimally invasive procedure, operating time, blood loss, transfusion rate, conversion rate, intra- and postoperative complications and mortality rate. Cases were also sub-analysed according to their pathologies to determine the differences in complication rate between stone disease, pyelonephritis, non-functioning kidney and other benign lesions. To contextualize procedural complexity, the simple nephrectomy data were compared with those obtained from the BAUS stage T1 radical nephrectomy audit.
RESULTS:
A total of 1 093 nephrectomies were performed (537 non-functioning kidneys, 142 stone disease, 129 nephrectomies secondary to pyelonephritis and 285 cases with other benign conditions). Of these, 76% were performed laparoscopically. Blood loss >500 mL was noted in 74 cases with a 4.8% blood transfusion rate. The intra- and postoperative complication rates were 5.2 and 11.9%, respectively. Of the 847 minimally invasive procedures, the conversion rate was 5.9%. Patients with stone disease have the highest intra- and postoperative complications (9.9 and 23.9%, respectively) compared with other benign pathologies. The total number of T1 radical nephrectomies performed was 1 095. In comparison with T1 radical nephrectomy, simple nephrectomy carries an increased risk of conversion to an open procedure (1.8 times), a higher rate of blood transfusion (4.8 vs 2.8%), and a higher risk of intra- and postoperative complications (5.2 vs 3.7% and 11.9 vs 10%, respectively).
CONCLUSION:
The present study reports the largest series of nephrectomies performed for benign disease and the resultant data now support the bespoke preoperative counselling of patients. Furthermore, it confirms the commonly held view that simple nephrectomy can be more difficult than its radical counterpart. The authors suggest that the term 'simple nephrectomy' is changed to 'benign nephrectomy'.
AuthorsBachar Zelhof, Iain G McIntyre, Sarah M Fowler, Richard D Napier-Hemy, Daniel M Burke, Ben R Grey, British Association of Urological Surgeons
JournalBJU international (BJU Int) Vol. 117 Issue 1 Pg. 138-44 (Jan 2016) ISSN: 1464-410X [Electronic] England
PMID25824808 (Publication Type: Journal Article)
Copyright© 2015 The Authors BJU International © 2015 BJU International Published by John Wiley & Sons Ltd.
Topics
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Databases, Factual
  • Female
  • Humans
  • Kidney Diseases (epidemiology, surgery)
  • Male
  • Middle Aged
  • Nephrectomy (adverse effects, statistics & numerical data)
  • Postoperative Complications (epidemiology)
  • Retrospective Studies
  • Treatment Outcome
  • United Kingdom (epidemiology)
  • Young Adult

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: