Benoit Peyronnet1, Benjamin Pradère2,3, Alexandre De La Taille4, Franck Bruyère3, Nicolas Doumerc5, Stéphane Droupy6, Christophe Vaessen7, Hervé Baumert8, Jean-Christophe Bernhard9,10, Morgan Rouprêt7, Arnaud Mejean11, Karim Bensalah2. 1. Department of Urology, University of Rennes, 2 rue Henri Le Guilloux, 35000, Rennes, France. peyronnetbenoit@hotmail.fr. 2. Department of Urology, University of Rennes, 2 rue Henri Le Guilloux, 35000, Rennes, France. 3. Department of Urology, University of Tours, Tours, France. 4. Department of Urology, Henri-Mondor Hospital, Créteil, France. 5. Department of Urology, University of Toulouse, Toulouse, France. 6. Department of Urology, University of Nimes, Nimes, France. 7. Department of Urology, La Pitié-Salpétrière Hospital, Paris, France. 8. Department of Urology, Saint-Joseph Hospital, Paris, France. 9. Department of Urology, University of Bordeaux, Bordeaux, France. 10. French Research Network on Kidney Cancer (uroCCR), Bordeaux, France. 11. Department of Urology, Georges Pompidou Hospital, Paris, France.
Abstract
OBJECTIVES: We aimed to assess the impact of a postoperative drainage after RPN. METHODS: A retrospective multicentric study included RPN performed at eight centers between 2010 and 2014. Three centers stopped using postoperative drainage early in their RPN experience, whereas other institutions systematically left a drain. Preoperative characteristics, complication rates, need for postoperative imaging or procedure (surgical or radiological) and length of hospital stay were compared between the two groups [drainage (D) and no drainage (ND)]. RESULTS: Among 636 RPNs, 140 were done without drainage (22 %). In the ND group, surgeons were more experienced (>50 cases: 55.7 vs. 15.1 %; p < 0.0001), and tumors were more complex (RENAL score: 7.6 vs. 6.5; p < 0.0001). Complication rates were similar in both groups (21.9 vs. 20.2 %; p = 0.67). The omission of postoperative drainage did not increase requirement of CT scan (RR = 1.03; 95 % CI 0.64-1.67). Length of hospital stay was shorter in the ND group (4.5 vs. 5.5 days; p = 0.007). There were six urinary fistulas: four in the D group (0.8 %) and two in the ND group (1.4 %; p = 0.49). A CT scan was done to confirm the diagnosis of fistula in every case. In multivariate analysis, the omission of drainage was not associated with increased need of postoperative CT scan or major complications but was a predictor of decreased length of stay. CONCLUSION: The omission of postoperative drainage does not seem to increase the risk of postoperative complications and could safely be omitted after RPN.
OBJECTIVES: We aimed to assess the impact of a postoperative drainage after RPN. METHODS: A retrospective multicentric study included RPN performed at eight centers between 2010 and 2014. Three centers stopped using postoperative drainage early in their RPN experience, whereas other institutions systematically left a drain. Preoperative characteristics, complication rates, need for postoperative imaging or procedure (surgical or radiological) and length of hospital stay were compared between the two groups [drainage (D) and no drainage (ND)]. RESULTS: Among 636 RPNs, 140 were done without drainage (22 %). In the ND group, surgeons were more experienced (>50 cases: 55.7 vs. 15.1 %; p < 0.0001), and tumors were more complex (RENAL score: 7.6 vs. 6.5; p < 0.0001). Complication rates were similar in both groups (21.9 vs. 20.2 %; p = 0.67). The omission of postoperative drainage did not increase requirement of CT scan (RR = 1.03; 95 % CI 0.64-1.67). Length of hospital stay was shorter in the ND group (4.5 vs. 5.5 days; p = 0.007). There were six urinary fistulas: four in the D group (0.8 %) and two in the ND group (1.4 %; p = 0.49). A CT scan was done to confirm the diagnosis of fistula in every case. In multivariate analysis, the omission of drainage was not associated with increased need of postoperative CT scan or major complications but was a predictor of decreased length of stay. CONCLUSION: The omission of postoperative drainage does not seem to increase the risk of postoperative complications and could safely be omitted after RPN.
Authors: Ricardo Sánchez-Ortiz; Lydia T Madsen; David A Swanson; Steven E Canfield; Christopher G Wood Journal: J Urol Date: 2004-01 Impact factor: 7.450
Authors: Jeong Ho Kim; Yong Hyun Park; Yong June Kim; Seok Ho Kang; Seok Soo Byun; Cheol Kwak; Sung Hoo Hong Journal: World J Urol Date: 2015-01-14 Impact factor: 4.226
Authors: Hendrik Van Poppel; Luigi Da Pozzo; Walter Albrecht; Vsevolod Matveev; Aldo Bono; Andrzej Borkowski; Jean-Marie Marechal; Laurence Klotz; Eila Skinner; Thomas Keane; Ilse Claessens; Richard Sylvester Journal: Eur Urol Date: 2006-11-15 Impact factor: 20.096
Authors: Guilherme Godoy; Darren J Katz; Ari Adamy; Joseph E Jamal; Melanie Bernstein; Paul Russo Journal: J Urol Date: 2011-06-17 Impact factor: 7.450
Authors: Inderbir S Gill; Louis R Kavoussi; Brian R Lane; Michael L Blute; Denise Babineau; J Roberto Colombo; Igor Frank; Sompol Permpongkosol; Christopher J Weight; Jihad H Kaouk; Michael W Kattan; Andrew C Novick Journal: J Urol Date: 2007-05-11 Impact factor: 7.450