Radical nephrectomy and nephroureterectomy in the octogenarian and nonagenarian: comparison of laparoscopic and open approaches

Objectives. To retrospectively compare the outcome of laparoscopic and open radical nephrectomy or nephroureterectomy in patients 80 years old or older, inasmuch as the tolerance profile of major laparoscopic renal surgery in comparison to open surgery in the elderly patient has not been previously...

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Bibliographic Details
Published in:Urology (Ridgewood, N.J.) N.J.), 1999-06, Vol.53 (6), p.1121-1125
Main Authors: Hsu, Thomas H.S, Gill, Inderbir S, Fazeli-Matin, Surena, Soble, Jon J, Sung, Gyung Tak, Schweizer, Dana, Novick, Andrew C
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biological and medical sciences
Female
Humans
Kidney Neoplasms - surgery
Laparoscopy
Male
Medical sciences
Nephrectomy - methods
Postoperative Complications - epidemiology
Retrospective Studies
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the urinary system
Ureter - surgery
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Summary:Objectives. To retrospectively compare the outcome of laparoscopic and open radical nephrectomy or nephroureterectomy in patients 80 years old or older, inasmuch as the tolerance profile of major laparoscopic renal surgery in comparison to open surgery in the elderly patient has not been previously reported. Methods. Since September 1997, 11 patients 80 years old or older underwent retroperitoneal laparoscopic radical nephrectomy or nephroureterectomy for cancer. These patients were compared with 6 consecutive patients 80 years old or older who underwent comparable open surgery at our institution since January 1994. No tumor had computed tomographic evidence of lymphatic, vascular, or perirenal extension. Results. Baseline parameters were comparable between the laparoscopic and open groups. The laparoscopic group had a similar median surgical time (210 minutes versus 175 minutes; P = 0.1) and blood loss (150 mL versus 125 mL; P = 0.8) compared with the open group. However, specimen weight was larger in the laparoscopic group (568 g versus 292 g; P = 0.04). Moreover, the laparoscopic group had a quicker resumption of oral intake (less than 1 day versus 4 days; P
ISSN:0090-4295
1527-9995
DOI:10.1016/S0090-4295(99)00021-7