Routine drain placement after partial nephrectomy is not always necessary Journal Article
| Authors: | Godoy, G.; Katz, D. J.; Adamy, A.; Jamal, J. E.; Bernstein, M.; Russo, P. |
| Article Title: | Routine drain placement after partial nephrectomy is not always necessary |
| Abstract: | Purpose: To our knowledge the benefit of routine drainage after partial nephrectomy has never been investigated, although a drain after partial nephrectomy can be associated with morbidity. We report our initial experience with omitting the drain in select cases of superficial renal cortical tumors. Materials and Methods: From a surgery database we identified 512 consecutive open partial nephrectomies performed by a single surgeon between January 2005 and May 2009 using standardized technique. The study group included 75 evaluable patients (14.6%) who did not have a drain placed. Clinical data, surgical information, histological type and postoperative complications within 90 days of the procedure using the modified Clavien system were included in analysis. Results: Median patient age was 64 years (IQR 49, 70) and 56.8% of the patients were male. Median tumor size was 2.0 cm (IQR 1.5, 3.0) and more than 70% were malignant. A total of 38 patients (50.7%) underwent renal artery clamping and cold ischemia with a median clamp time of 30 minutes. The overall complication rate was 13.3% (10 patients). In 4 patients (5.3%) complications were related to an absent drain, including grade I urinary leak, grade II perirenal collection, grade III urinoma requiring percutaneous drainage and grade III urinary leak with urosepsis, respectively. No deaths occurred in this cohort. Conclusions: Omitting drainage after partial nephrectomy in a select group of patients without collecting system entry is feasible and safe. The decision to place a drain after partial nephrectomy for small renal cortical tumors must be made intraoperatively and should be tailored to each case. © 2011 American Urological Association Education and Research, Inc. |
| Keywords: | kidney neoplasms; nephrectomy; postoperative complications; kidney; drainage |
| Journal Title: | Journal of Urology |
| Volume: | 186 |
| Issue: | 2 |
| ISSN: | 0022-5347 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2011-08-01 |
| Start Page: | 411 |
| End Page: | 415 |
| Language: | English |
| DOI: | 10.1016/j.juro.2011.03.151 |
| PROVIDER: | scopus |
| PUBMED: | 21683403 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 17 August 2011" - "CODEN: JOURA" - "Source: Scopus" |
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