Comparative characteristic of nephrectomy depending on surgical access and type of kidney damage

Objective: To analyze the comparative results of nephrectomy indicators in cases of severe and mild paranephritis, without pyonephrosis and nephroureterectomy, depending on the nosology and type of kidney damage (benign diseases, space-occupying lesions, donor kidneys). Materials and Methods: An analysis of 803 case histories of patients who underwent nephrectomy using various methods was conducted. The effectiveness of these methods was also assessed depending on the clinical situation. Results: Surgical success rates in patients with severe paranephritis were worse than in patients with mild paranephritis. In the group of patients who underwent nephrectomy without regard to pyonephrosis or nephroureterectomy, we found no significant differences in outcomes across all groups. Nephrectomy outcomes for donor nephrectomy were statistically more favorable than those for nephrectomy for benign kidney disease and neoplasms (except for surgical duration). Nephrectomy for renal neoplasms, compared with nephrectomy for benign diseases, had advantages in the following indicators: the length of the incision for kidney removal (on average by 3.6 cm, p<0.0001), the volume of blood loss (on average by 46.8 ml, p<0.0001), stay in intensive care (p<0.0001), the consumption of narcotic analgesics (p<0.0001), complications after surgery (p<0.0006) and the number of hospital days after surgery (p<0.0001). In the retroperitoneoscopic donor nephrectomy group, age (by an average of 6.8 years; p=0.0053), weight (by an average of 5.4 kg; p=0.0282) and height (by an average of 4.7 cm; p=0.0230) differed statistically significantly compared to the laparoscopic access group. Conclusion: The presented scientifically based approach enables specialists performing organ-removal surgeries for various benign and malignant kidney pathologies to effectively diagnose and select the optimal surgical treatment method depending on the specific situation, as well as the clinic's capabilities.