The present study aimed to compare the safety and feasibility of laparoscopic and hand-assisted laparoscopic nephrectomy in patients with IRD.

We retrospectively analyzed the data of 107 patients who underwent LN and HALN for IRD, including pyonephrosis, renal tuberculosis, hydronephrosis, and xanthogranulomatous pyelonephritis. Patient demographics, operative outcomes, and postoperative recovery and complications were compared between the LN and HALN groups. Multivariable logistic regression analysis was conducted to identify the independent predictors of adverse effects.

Fifty-five subjects in the LN group and 52 subjects in the HALN group were enrolled in this study. In the LN group, laparoscopic nephrectomy was successfully performed in 50 patients, while four patients were converted to HALN and one case was converted to open procedure. In the HALN group, operations were completed in 51 patients, and conversion to open surgery was necessary for one patient. Multivariable logistic regression revealed that severe perinephric adhesions were an independent predictor of adverse outcomes.

The study concluded that both LN and HALN appear to be safe and feasible for IRD. As a still minimally invasive approach, HALN provided an alternative to IRD or conversion in LN.