Abstract
Introduction and objectives
To analyze postoperative complications and to assess for significant predictive factors
during partial nephrectomy (PN) using a large multicenter dataset.
Methods
Patients who underwent PN for clinical T1 renal tumors at 19 urological Italian centers
(Registry of Conservative Renal Surgery [RECORd] project) were evaluated between 2009
and 2012. Anthropometric data, comorbidities and perioperative outcomes were analyzed.
Complications were divided as intra- and postoperative, medical and surgical, as appropriate.
The severity of postoperative complications was graded according to the modified Clavien
classification system. Patients who experienced intraoperative complications were
excluded from the analyses for the potential confounding effect in the evaluation
of predicting factors for postoperative complications.
Results
Overall, 979 patients were analyzed: open, laparoscopic and robot-assisted (available
since 2011) surgical approaches were used in 522 (56.4%), 286 (30.9%) and 117 (12.6%)
cases, respectively. Surgical postoperative complications were reported in 121 (13.1%)
cases (32 (3.5%) were Clavien 3), medical were reported in 52 (5.6%) cases (3 (0.3%)
were Clavien 3). No Clavien 4 complications were reported. At multivariable analysis,
ECOG score ≥1 (OR 1.98; p = 0.002), lower preoperative hemoglobin (OR 0.71; p < 0.0001)
and open surgical approach (2.91; p = 0.02) were significant predictive factors of
overall surgical postoperative complications, ECOG score ≥1 (OR 1.93; p = 0.04) and
surgical approach (p = 0.05) were significant predictive factors of Clavien 3 either
surgical or medical postoperative complications.
Conclusions
Comorbidities and surgical approach should be considered in preoperative evaluation
of patients undergoing PN, as they resulted to play a significant role in the occurrence
of postoperative complications.
Keywords
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Article info
Publication history
Published online: November 04, 2016
Accepted:
October 14,
2016
Identification
Copyright
© 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
