Open renal approach: comparative analysis of sub-costal incision versus trans-costal incision with excision of 12[th] rib

ABSTRACT

To compare the outcome of sub-costal incision with trans-costal incision and 12[th] rib resection in the surgical approach for benign renal disease. It is a prospective, analytical, comparative study using randomized controlled trial [RCT], conducted at Fatima hospital-Baqai medical university [Karachi], from June 2005 to December 2008. In total 54 patients were enrolled in the study, who either underwent pyelolithotomy or nephrectomy via sub-costal [group A 27 patients] or trans-costal incision [group B 27 patients]. Incision time, duration of operation, postoperative pain, duration of hospital stay, and peroperative and postoperative complications were noted. Incision time and duration of operation were longer in group B patients [p-value 0.002 and 0.029 respectively]; pain perception was also markedly high in this group [p=0.001]. Total period to stay in hospital was marginally higher in group B [p=0.212]. Peroperative and postoperative complications were also slightly higher in group B patients [p-value 0.064 and 0.838 respectively]. Sub-costal renal approach provides adequate exposure, is quick, safe and less painful