Abstract：Objective:To explore the operation methods and results of retroperitoneal laparoscopic nephrectomy for the treatment of nonfunctioning kidney with giant hydronephrosis. Methods:Retroperitoneal laparoscopic nephrectomy was performed on 36 cases of nonfunctioning kidney with hydronephrosis. The retroperitoneal cavity was established. Afterwards, 3 trocars were inserted through the lumbar region, the kidney was dissociated partially, and a small hole was made, followed by intrarenal fluid drainage. Then the kidney was fully mobilized, the renal pedicle was exposed, and blocked with Hem-o-lok, the nonfunctioning kidney was taken out in a specimen bag, and the retroperitoneal drainage catheter was placed. The operation time, blood loss, complications during and after operation and the operative efficacy were observed. Results:All the operations were successfully completed. The mean operative time was (92.5±32.8) min (60-180 min), and blood loss was (31.4±5.2) mL(10-100 mL). Drainage catheter was removed 2-3 days after operation. There were no massive hemorrhage, infection, peritoneum rupture, intraabdominal visceral injury, and other severe complications. As for the cases with hydronephrotic fluid volume more than 3 000 mL, renal fascial planes and compartments were carefully observed. Conclusions:Retroperitoneal laparoscopic nephrectomy for nonfunctioning kidney with giant hydronephrosis was proved to be minimally invasive, safe and effective. With respect to the patients with hydronephrotic fluid volume more than 3 000 mL, anatomical spaces should be observed carefully during operation, and after operation, the changes in the renal function should be assessed closely.
