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Minerva Urologica e Nefrologica 2019 February;71(1):47-54

DOI: 10.23736/S0393-2249.18.03202-2


language: English

The occurrence of intraoperative complications during partial nephrectomy and their impact on postoperative outcome: results from the RECORd1 project

Andrea MINERVINI 1 , Andrea MARI 1, Marco BORGHESI 2, Alessandro ANTONELLI 3, Riccardo BERTOLO 4, Giampaolo BIANCHI 5, Eugenio BRUNOCILLA 2, Vincenzo FICARRA 6, Cristian FIORI 4, Nicola LONGO 7, Vincenzo MIRONE 7, Giuseppe MORGIA 8, Francesco PORPIGLIA 4, Bernardo ROCCO 9, Sergio SERNI 1, Claudio SIMEONE 3, Riccardo TELLINI 1, Alessandro VOLPE 10, Marco CARINI 1, Riccardo SCHIAVINA 2

1 Department of Urology, Careggi Hospital, University of Florence, Florence, Italy; 2 Department of Urology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; 3 Department of Urology, Spedali Civili Hospital, Brescia, Italy; 4 Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy; 5 Department of Urology, Polyclinic of Modena, University of Modena, Modena, Italy; 6 Department of Urology, University of Padua, Padua, Italy; 7 Department of Urology, Federico II Hospital, University of Naples, Naples, Italy; 8 Department of Urology, University of Catania, Catania, Italy; 9 Department of Urology, Ca’ Granda Foundation and Insitute for Research and Care, Maggiore Polyclinic Hospital, University of Milan, Milan, Italy; 10 Department of Urology, Maggiore della Carità Hospital, Novara, Italia

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.

KEY WORDS: Intraoperative complications - Laparoscopy - Nephrectomy - Intraoperative complications - Robotics - Computer-assisted surgery

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