The occurrence of intraoperative complications during partial nephrectomy and their impact on postoperative outcome: results from the RECORd1 project.
Adult
Aged
Aged, 80 and over
Female
Humans
Intraoperative Complications
/ epidemiology
Kidney Cortex
/ surgery
Kidney Neoplasms
/ surgery
Male
Middle Aged
Nephrectomy
/ adverse effects
Postoperative Complications
/ epidemiology
Prospective Studies
Robotic Surgical Procedures
Treatment Outcome
Urologic Surgical Procedures
Journal
Minerva urologica e nefrologica = The Italian journal of urology and nephrology
ISSN: 1827-1758
Titre abrégé: Minerva Urol Nefrol
Pays: Italy
ID NLM: 8503649
Informations de publication
Date de publication:
Feb 2019
Feb 2019
Historique:
pubmed:
12
9
2018
medline:
9
4
2019
entrez:
12
9
2018
Statut:
ppublish
Résumé
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. Data of 1055 patients who underwent PN for cortical renal masses were recorded from a multicenter prospective observational study (RECORd1 project). 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. Efforts should be made to minimize the risk of intraoperative complications during PN, and, in that case, patients should be carefully monitored.
Sections du résumé
BACKGROUND
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
METHODS
Data of 1055 patients who underwent PN for cortical renal masses were recorded from a multicenter prospective observational study (RECORd1 project).
RESULTS
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
CONCLUSIONS
Efforts should be made to minimize the risk of intraoperative complications during PN, and, in that case, patients should be carefully monitored.
Identifiants
pubmed: 30203939
pii: S0393-2249.18.03202-2
doi: 10.23736/S0393-2249.18.03202-2
doi:
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM