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

2019; Edizioni Minerva Medica; Volume: 71; Issue: 1 Linguagem: Inglês

10.23736/s0393-2249.18.03202-2

1827-1758

Andrea Minervini, Andrea Mari, Marco Borghesi, Alessandro Antonelli, Riccardo Bertolo, Giampaolo Bianchi, Eugenio Brunocilla, Vincenzo Ficarra, Cristian Fiori, Nicola Longo, Vincenzo Mirone, Giuseppe Morgia, F. Porpiglia, Bernardo Rocco, Sergio Serni, Claudio Simeone, R. Tellini, Alessandro Volpe, Marco Carini, Riccardo Schiavina,

Organ Donation and Transplantation

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.