Andrea Minervini1, Andrea Mari2, Marco Borghesi3, Alessandro Antonelli4, Riccardo Bertolo5, Giampaolo Bianchi6, Eugenio Brunocilla3, Vincenzo Ficarra7, Cristian Fiori5, Nicola Longo8, Vincenzo Mirone8, Giuseppe Morgia9, Francesco Porpiglia5, Bernardo Rocco10, Sergio Serni2, Claudio Simeone4, Riccardo Tellini2, Alessandro Volpe11, Marco Carini2, Riccardo Schiavina3. 1. Department of Urology, Careggi Hospital, University of Florence, Florence, Italy - andreamine@libero.it. 2. Department of Urology, Careggi Hospital, University of Florence, Florence, Italy. 3. Department of Urology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. 4. Department of Urology, Spedali Civili Hospital, Brescia, Italy. 5. Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy. 6. Department of Urology, Polyclinic of Modena, University of Modena, Modena, Italy. 7. Department of Urology, University of Padua, Padua, Italy. 8. Department of Urology, Federico II Hospital, University of Naples, Naples, Italy. 9. Department of Urology, University of Catania, Catania, Italy. 10. Department of Urology, Ca' Granda Foundation and Insitute for Research and Care, Maggiore Polyclinic Hospital, University of Milan, Milan, Italy. 11. Department of Urology, Maggiore della Carità Hospital, Novara, Italia.
Abstract
BACKGROUND: The aim of this study was to analyze the predictive factors of intraoperative complications in patients submitted to PN and the impact of intraoperative complications on postoperative outcomes. METHODS: Data of 1055 patients who underwent PN for cortical renal masses were recorded from a multicenter prospective observational study (RECORd1 project). RESULTS: Overall, 48 (5%) patients experienced 49 intraoperative complications (four medical, 45 surgical). At multivariable analysis, age (OR=1.02, 95% CI: 1.00-1.08, P=0.03), imperative versus elective surgical indication (OR=2.55, 95% CI: 1.12-5.85, P=0.03), open (OR=5.76, 95% CI: 1.05-9.21, P=0.01) and laparoscopic (OR=2.35, 95% CI: 1.11-4.95, P=0.03) versus robotic approaches resulted independent predictive factors of intraoperative complications. Patients experiencing intraoperative complications had a significantly higher rate of overall postoperative complications (41.6% vs. 17.3%, P<0.0001), surgical postoperative complications (29.2% vs. 12.6%, P<0.0001), Clavien 2 surgical postoperative complications (14.6% vs. 7.2%, P=0.05) and a significantly longer length of stay (8 [6-9] vs. 7 [5-8] days, P<0.0001) than those with an uneventful intraoperative course. CONCLUSIONS: Efforts should be made to minimize the risk of intraoperative complications during PN, and, in that case, patients should be carefully monitored.
BACKGROUND: The aim of this study was to analyze the predictive factors of intraoperative complications in patients submitted to PN and the impact of intraoperative complications on postoperative outcomes. METHODS: Data of 1055 patients who underwent PN for cortical renal masses were recorded from a multicenter prospective observational study (RECORd1 project). RESULTS: Overall, 48 (5%) patients experienced 49 intraoperative complications (four medical, 45 surgical). At multivariable analysis, age (OR=1.02, 95% CI: 1.00-1.08, P=0.03), imperative versus elective surgical indication (OR=2.55, 95% CI: 1.12-5.85, P=0.03), open (OR=5.76, 95% CI: 1.05-9.21, P=0.01) and laparoscopic (OR=2.35, 95% CI: 1.11-4.95, P=0.03) versus robotic approaches resulted independent predictive factors of intraoperative complications. Patients experiencing intraoperative complications had a significantly higher rate of overall postoperative complications (41.6% vs. 17.3%, P<0.0001), surgical postoperative complications (29.2% vs. 12.6%, P<0.0001), Clavien 2 surgical postoperative complications (14.6% vs. 7.2%, P=0.05) and a significantly longer length of stay (8 [6-9] vs. 7 [5-8] days, P<0.0001) than those with an uneventful intraoperative course. CONCLUSIONS: Efforts should be made to minimize the risk of intraoperative complications during PN, and, in that case, patients should be carefully monitored.
Authors: Suresh de Silva; Kathleen Rebecca Lockhart; Peter Aslan; Peter Nash; Anthony Hutton; David Malouf; Dominic Lee; Paul Cozzi; Fiona MacLean; James Thompson Journal: BMC Urol Date: 2021-04-22 Impact factor: 2.264