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
Notes: --- - "Export Date: 17 August 2011" - "CODEN: JOURA" - "Source: Scopus"
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MSK Authors
  1. Paul Russo
    449 Russo
  2. Darren Jonathan Katz
    36 Katz
  3. Guilherme Godoy
    23 Godoy
  4. Joseph Edmund Jamal
    1 Jamal