<p class="MDPI12title"><span style="mso-bidi-font-size: 18.0pt; mso-ligatures: standardcontextual;">Abdominal Nerve Injuries Associated with Lumbotomies: A Retrospective Analysis and Literature Review

Background and Objectives: The lumbotomy approach is a well-established surgical technique for renal procedures, including nephron-sparing surgery, radical nephrectomy, and heminephrectomy. Although effective, this access is associated with the risk of abdominal wall nerve injuries, which may result in sensory deficits and the development of a so-called flank bulge. This study aimed to assess the incidence and predictors of abdominal nerve damage in patients who underwent lumbotomies. Materials and Methods: A retrospective review of 407 patients treated between 2018 and 2023 was conducted. Outcomes included the presence of abdominal wall protrusions, subjective burden, scar hypoesthesia, and extended sensory disturbance. Associations between variables were analyzed using multivariate regression models. Results: Flank bulges were observed in 21.6% of the patients, with more than half reporting it as bothersome. Scar hypoesthesia was noted in 14.0% of patients, while extended hypoesthesia occurred in 7.1%. The highest prevalence of bulging was observed in the nephron-sparing surgery group (27.0%). Regression models confirmed strong associations between bulging, perceived severity, and scar hypoesthesia. The demographic and biochemical parameters were not significant predictors. Conclusions: Abdominal nerve injuries following lumbotomy are relatively common and clinically relevant. These complications may affect both body contour and the patient’s quality of life. Preventive measures and the use of minimally invasive techniques, whenever feasible, should be considered.