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The following is a summary of “Laparoscopic vs. Open nephrectomy for inflammatory renal conditions: a meta-analysis emphasizing safety,” published in the April 2025 issue of BMC Urology by Alsmadi et al. 

Nephrectomy for inflammatory renal conditions (IRCs) is challenging, regardless of the surgical method. 

Researchers conducted a retrospective study to evaluate the safety of laparoscopic nephrectomy (LN) versus open nephrectomy (ON) for IRCs, including xanthogranulomatous pyelonephritis (XGP), pyonephrosis, and renal tuberculosis. 

They systematically reviewed studies comparing LN and ON in adults with IRCs, following PRISMA/Cochrane guidelines. Inclusion required direct LN vs. ON comparisons and perioperative outcomes, while exclusions included pediatric cohorts and studies conflating converted LN cases with ON groups. 

The results showed that 13 studies with 868 patients met the inclusion criteria, with 398 (45.9%) undergoing ON and 470 (54.1%) undergoing LN. LN showed a 28% reduction in overall complications compared to ON (RR = 0.72, 95% CI [0.6–0.86]; P = 0.0004). A non-significant reduction in high-grade complications was observed (RR = 0.65, 95% CI [0.4–1.06]; P = 0.09). LN was associated with 53% fewer blood transfusions (RR = 0.47, P < 0.0001), reduced blood loss in patients with XGP (MD = -130.8 mL; 95% CI [-203.35 to -58.21]), and shorter hospital stays (PMD = -3.04 days; P < 0.00001). LN also had longer operative times (PMD = +39.05 min; P = 0.03). 

Investigators found LN to be a safer alternative to ON for IRCs, with fewer complications, shorter hospitalization, and reduced transfusions despite longer operative times. They emphasized the importance of surgeon expertise and patient-specific selection for optimal outcomes. 

Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-025-01781-z