Outcomes of initial 100 cases of laparoscopic nephrectomy at tertiary care center (PKLI)

Objective: Laparoscopic nephrectomy has been adopted by many centers in the last few decades. However, there are a few inherent challenges while adopting laparoscopic nephrectomy in a new unit. These include a significant learning curve required to adopt this modality. This study aimed to share the initial experience of adopting laparoscopic nephrectomy at our center. Methods: In total, 101 patients were analyzed in the study. These patients underwent laparoscopic radical or simple nephrectomy (for renal mass and noncancer renal cases respectively) at Department of Urology, Pakistan Kidney and Liver Institute and Research Centre, Lahore from April 2018 till January 2021. Data were entered in the statistical analysis software file. Analysis was attained by utilizing SPSS version 20. Implementation of Mean along with standard deviation values was utilized in the case of the continuous variables. While frequency/percentages represented categorical factors. Results: The mean age of patients was 42.81 +/- 15.49 years and their overall BMI was 26.41 +/- 5.30 kg/m2. Out of these, 57 (56.43%) were males and 44(43.56%) were female. Eighteen percent of patients had a previous surgical history on the ipsilateral side. Total operative time was 163.98 +/- 58.02 minutes while mean hospital stay reached 3.2 +/- 0.87 days. The tumor-free margin was attained in all cases of radical nephrectomy. Based on Clavien-Dindo classification, Grade-1 (n=3; 2.97%), Grade-2 (n=6; 5.94%), Grade-3A (n=1; 0.99%), and Grade-3B (n=1; 0.99%) complications were observed. Conclusion: In a newly developed urology center, laparoscopic nephrectomy can be a daunting task. Good teamwork among the surgical team members and careful selection of cases can result in satisfactory procedural outcomes.