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

The occurrence of intraoperative complications during partial nephrectomy has a significant impact on postoperative outcome: results from the RECORd1 project / A. Minervini, A. Mari, M. Borghesi, A. Antonelli, R. Bertolo, G. Bianchi, E. Brunocilla, V. Ficarra, C. Fiori, N. Longo, V. Mirone, G. Morgia, F. Porpiglia, B. Rocco, S. Serni, C. Simeone, R. Tellini, A. Volpe, M. Carini, R. Schiavina. - In: MINERVA UROLOGICA E NEFROLOGICA. - ISSN 0393-2249. - 71:1(2019 Feb), pp. 47-54. [10.23736/S0393-2249.18.03202-2]

The occurrence of intraoperative complications during partial nephrectomy has a significant impact on postoperative outcome: results from the RECORd1 project

B. Rocco;
2019

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
Intraoperative complications; Laparoscopy; Nephrectomy; Intraoperative complications; Robotics; Computer-assisted surgery;
Settore MED/24 - Urologia
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/876295
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