Objective: To gain information about the indications for and complications of conventional nephrectomy, also to create standards for future evaluation of nephrectomies performed by minimal invasive techniques.Methods: We present a historical 20 years’ series of 646 consecutive nephrectomies performed in the period of 1978–1997. Malignant disease led to the operation in 437 cases, of which 98 were urothelial tumors in the renal pelvis or ureter. 209 kidneys were removed due to benign conditions. The incidence of nephrectomy for benign conditions has declined from 75 in the first 5–year period to 32 in the last.Results and Discussion: Postoperative complications occurred in 100 patients (15.5%). Nephrectomy for malignant disease had a significantly higher rate of complications than operations for benign conditions (p<0.001), especially hemorrhagic complications and pneumonias were more frequent. There were no differences as a result of the operative approach. Reoperation was carried out in 3.0% of the cases. Overall mortality rate (<30 days) was 3.1%.

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