Int J Urol. 2007;14:17-20
Laparocopic nephrectomy can be performed safely and effectively in patients with three or more comorbidities, a Japanese study shows.

Yukio Naya, MD, and his colleagues at Chiba University compared laparoscopic nephrectomy outcomes in 20 patients with three or more comorbidities (group A) and 46 patients with fewer than three comorbidities (group B). The mean number of comorbidities was 3.95 in Group A (range 3-6) and 1.10 in group B (range 0-2). Group A patients were significantly older than group B patients (70.1 vs. 59.0 years).

Mean tumor size was similar in both groups (4.21 and 4.14, respectively). Group A had worse American Society of Anesthesiology physical status scores than group B.

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Mean duration of surgery and estimated blood loss were similar for groups A and B (204 and 217 minutes, respectively, and 164 and 285 mL, respectively). The incidence of atelectasis postoperatively was also similar in both groups; the condition was cured one to two days after surgery in all cases without special care.

The two groups had similar lengths of hospital stay (17.5 days in group A and 18.5 days in group B) and time to first walking (1.3 and 1.5 days) and time to first oral intake (1.7 and 2.4 days).