What are the possible complications of extraperitoneal nephrectomy?

Updated: Sep 24, 2019
  • Author: Michael Grasso, III, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

Answer

Major complications reported with RLN are similar to those noted with TLN and open radical nephrectomy and are not unique to this approach. Minor complications, including diaphragm irritation, hypercarbia, failed specimen entrapment, and transient subcutaneous emphysema have been reported. In a meta-analysis of complications of laparoscopic renal surgery, Pareek et al described a minor complication rate of 11.3% and a major complication rate of 0.5% for RLN, which was not significantly different when compared with TLN. [50, 51]

Gupta et al compared 505 RLN to 112 open nephrectomies for benign pathology and found decreased blood transfusions (0.8% vs 4.5%) and decreased intraoperative (7.5% vs 22.4%) and postoperative (5.1% vs 22.3%) complications compared with open; [52] 29 conversions (5.7%) were reported, nearly half of which were in the first 100 consecutive patients.

Liapis et al reviewed complications from 600 retroperitoneoscopic procedures performed over 10 years, including 284 cases of RLN. [53] They describe 15 transfusions (5.3%), 15 conversions (5.3%), and 12 surgical complications (4.2%).


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