ABSTRACT
Objective To evaluate the safety and feasibility of total retroperitoneal laparoscopic nephroureterectomy for a tuberculous non-functional kidney. Methods A total of 15 individuals diagnosed with unilateral non-functional kidney secondary to tuberculosis were encountered from January 2013 to January 2016. There were 12 male and 3 female patients with an average age of 47 (range 36~64 years old) in the cohort. All patients had normal renal function on the contralateral side and underwent the standard three-drug antituberculosis treatment for at least four weeks before surgery. Total retroperitoneal laparoscopic nephroureterectomy was performed in all patients, and the enlarged section of the distal ureter was managed using different auto-suture techniques. Results All the operations were successfully performed without conversion. The median operative time was 109 min (range, 75~138 min), the median blood loss was 157 ml (range, 70~230 ml), and the median hospitalization time was 7 days (range, 5~11 days). Renal vein injury, lumbar vein injury and rupture of distal ureter occurred in 1 patient, respectively. Peritoneum injury was observed in 3 patients. No serious perioperative complications occurred. Anti-tuberculosis chemotherapy was prescribed to all patients, with the entire course of treatment lasting five months. No recurrenceof tuberculosis of the bladder or the contralateral kidney was observed during the median follow-up period of 25 months. Conclusion Total retroperitoneal laparoscopic nephroureterectomy is a safe and feasible approach for the treatment of tuberculous non-functional kidneys, and it is minimal and rapid recuperation.