Laparoscopic Versus Open Nephrectomy : Clinical Effectivness and Cost Analysis

Inclusion criteria

• American Society of Anesthesiology score 1-3.
• Indication for :

• Simple total nephrectomy or hemi nephrectomy: benign chronic inflammatory non-functioning kidney
• Partial nephrectomy: localized renal mass ≤7 cm suitable for nephron-sparing surgery.
• Radical nephrectomy or Radical nephrouretrectomy with bladder cuff: localized renal tumor requiring complete nephrectomy without major vascular invasion.
• Patient deemed fit for general anesthesia and surgery.
• Patient provides written informed consent.

Exclusion criteria

• emergency surgery, dialysis-dependent patients, planned hybrid procedures.
• Patients with incomplete data
• Patients with metastatic disease at presentation.
• Prior extensive ipsilateral retroperitoneal surgery or severe adhesions precluding Laparoscopy.
• Need for concomitant major procedures (eg, large bowel resection) at index operation.
• Locally advanced tumor with obvious major vascular involvement requiring complex vascular reconstruction.
• Uncorrected coagulopathy.
• Pregnancy or Obese patient (BMI > 40)
• Inability to provide informed consent or comply with follow-up.