Retroperitoneoscopic nephrectomy v classic lumbotomy for pyonephrosis

PURPOSE: To describe our experience and operative technique for retroperitoneoscopic nephrectomy for pyonephrosis and to compare the results with those of open surgery. PATIENTS AND METHODS: Since October 1998, 23 successful retroperitoneoscopic nephrectomies for pyonephrosis were performed in our institution (Group A). These patients were compared with 23 patients, matched by age, sex, and body weight, who underwent classic lumbotomy for pyonephrosis (Group B). The two groups were compared in terms of operative time, blood loss, hospital stay, wound complications, and time of return to previous occupation. RESULTS: All the features studied except operative time were significantly different in favor of laparoscopy. CONCLUSION: Although technically difficult, retroperitoneoscopic nephrectomy for pyonephrosis is feasible. The extraperitoneal approach allows direct access to the renal hilum and helps avoid spillage of pus into the peritoneum.