Complications of transabdominal radical nephrectomy for renal cell carcinoma.

Our data from 193 patients demonstrate that most renal cell carcinomas can be removed with acceptable mortality and morbidity by transabdominal, transperitoneal radical nephrectomy through an upper midline incision. During this study only 12 tumors were removed via a different approach. Four patients, all with stage IV disease, died postoperatively, for an operative mortality of 2.1 per cent. The intraoperative and postoperative complication rates were 20.7 and 19.1 per cent, respectively. The most common complication was injury to the spleen, which occurred in 24 patients (12.4 per cent) and probably represents the greatest potential disadvantage of this approach.