Is simple nephrectomy the right nomenclature? - Comparing simple and radical nephrectomy to find the answer

Introduction: The word “simple” means “easily done” or “presenting no difficulty.” Hence, the “Simple Nephrectomy” (SN) operation should be “easy to perform.” However, in clinical practice, we have noticed that SN can be equally or more challenging surgery than radical nephrectomy (RN). This study assesses the need to modify the terminology of simple nephrectomy and identify the level of difficulty between SN and RN by comparing various intraoperative and postoperative factors. Methods: Patients undergoing open SN for benign renal disease (Group A) and RN for T1/2 renal tumors (Group B) were included in the study. Two groups were compared for operative time, estimated blood loss, postoperative complications, blood transfusion rate, and length of hospital stay. Results: A total of 114 patients were analyzed (82 in Group A and 32 in Group B). Mean age of the patients was higher in Group B (41.2 vs 53.6 years, P < 0.01). Mean operative time (136.8 vs 125.5 min, P = 0.08), incidence of postoperative complications (32.9% vs 25%, P = 0.50), length of hospital stay (7.2 vs 6.5 days, P = 0.09), estimated blood loss more than 500 ml (13.4% vs 9.3%, P = 0.75), and requirement of blood transfusion (10.9% vs 6.2%, P = 0.72) were higher in group A. Conclusion: The application of correct terminology is important to understand the subject and to convey the information. Simple nephrectomy is not an appropriate term as it is equally challenging to perform than its radical counterpart.