Complications of radical and partial nephrectomy in a large contemporary cohort Journal Article

Authors: Stephenson, A. J.; Hakimi, A. A.; Snyder, M. E.; Russo, P.
Article Title: Complications of radical and partial nephrectomy in a large contemporary cohort
Abstract: Purpose: Standardized criteria for reporting the early complications of urological procedures are lacking. We reviewed the early complications of radical nephrectomy (PN) and partial nephrectomy (PN) in a large contemporary cohort using a standardized complication grading scale. Materials and Methods: Between 1995 and 2002, 1,049 patients underwent RN (66%) or PN (34%) for renal cortical neoplasm. Records were reviewed for perioperative complications. Complications were graded using a 5-tiered scale based on the severity of impact or intensity of therapy required. Results: A total of 235 complications occurred in 180 patients (17%). Overall 55% and 31% of complications were grade I and grade II, respectively. There were 3 perioperative deaths (0.2%). PN was not associated with more complications compared to RN when accounting for other variables. PN cases had more procedure related complications compared to RN (9% versus 3%, respectively, p = 0.0001) due to complications of urinary leak and the reintervention rate was subsequently higher (2.5% versus 0.6%, p = 0.02). All but 1 of the reinterventions for PN involved either endoscopy or radiology. By multivariate analysis operative time (p <0.0001) and solitary kidney (p = 0.06) were associated with procedure related complications of PN. Conclusions: RN and PN are associated with low rates of serious morbidity and mortality. Compared to RN, PN is associated with higher rates of procedure related complications, the majority of which are minor. Overall, however, PN is not associated with more complications than RN.
Keywords: adolescent; adult; aged; aged, 80 and over; middle aged; major clinical study; cancer staging; laparoscopy; cohort studies; kidney carcinoma; kidney neoplasms; nephrectomy; postoperative complication; postoperative complications; length of stay; severity of illness index; partial nephrectomy; radical nephrectomy; carcinoma, renal cell; urine incontinence; operation duration; medical record; interventional radiology; surgical mortality; intermethod comparison; multivariate analysis; endoscopy; kidney cortex; solitary kidney; peroperative complication; humans; human; priority journal; article
Journal Title: Journal of Urology
Volume: 171
Issue: 1
ISSN: 0022-5347
Publisher: Elsevier Science, Inc.  
Date Published: 2004-01-01
Start Page: 130
End Page: 134
Language: English
DOI: 10.1097/01.ju.0000101281.04634.13
PROVIDER: scopus
Notes: J. Urol. -- Cited By (since 1996):145 -- Export Date: 16 June 2014 -- CODEN: JOURA -- Source: Scopus
Citation Impact
MSK Authors
  1. Paul Russo
    542 Russo
  2. Mark Snyder
    26 Snyder
  3. Abraham Ari Hakimi
    253 Hakimi