A Mari1, A Antonelli2, R Bertolo3, G Bianchi4, M Borghesi5, V Ficarra6, C Fiori3, M Furlan2, S Giancane1, N Longo7, V Mirone7, G Morgia8, F Porpiglia3, B Rovereto9, R Schiavina5, S Serni1, C Simeone2, A Volpe10, M Carini1, A Minervini11. 1. Department of Urology, Careggi Hospital, University of Florence, Florence, Italy. 2. Department of Urology, AO Spedali Civili di Brescia, Brescia, Italy. 3. Department of Urology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy. 4. Department of Urology, Policlinico di Modena, University of Modena, Modena, Italy. 5. Department of Urology, University of Bologna, S. Orsola Malpighi Hospital, Bologna, Italy. 6. Department of Urology, University of Padua, Padua, Italy. 7. Department of Urology, Policlinico Federico II, University of Naples, Naples, Italy. 8. Luna Foundation, Italy. 9. Department of Urology, I.R.C.C.S. Policlinico San Matteo, Pavia, Italy. 10. Department of Urology, Maggiore della Carità Hospital, Novara, Italy. 11. Department of Urology, Careggi Hospital, University of Florence, Florence, Italy. Electronic address: andreamine@libero.it.
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.
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.
Authors: Hugo Otaola-Arca; Alfred Krebs; Hugo Bermúdez; Raúl Lyng; Marcelo Orvieto; Alberto Bustamante; Conrado Stein; Andrés Labra; Marcela Schultz; Mario I Fernández Journal: Ann Surg Oncol Date: 2022-01-06 Impact factor: 5.344
Authors: Francesco Greco; Riccardo Autorino; Vincenzo Altieri; Steven Campbell; Vincenzo Ficarra; Inderbir Gill; Alexander Kutikov; Alex Mottrie; Vincenzo Mirone; Hendrik van Poppel Journal: Eur Urol Date: 2018-10-13 Impact factor: 24.267
Authors: Julio T Chong; David Paulucci; Marc Lubin; Alp Tuna Beksac; Greg Gin; John P Sfakianos; Ketan K Badani Journal: Ther Adv Urol Date: 2018-11-09