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

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

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)47-54
Number of pages8
JournalMinerva Urologica e Nefrologica
Volume71
Issue number1
DOIs
Publication statusPublished - Feb 1 2019

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Intraoperative Complications
Nephrectomy
Robotics
Statistical Factor Analysis
Observational Studies
Length of Stay
Prospective Studies
Kidney

Keywords

  • Computer-assisted surgery
  • Intraoperative complications
  • Laparoscopy
  • Nephrectomy
  • Robotics

ASJC Scopus subject areas

  • Nephrology
  • Urology

Cite this

The occurrence of intraoperative complications during partial nephrectomy and their impact on postoperative outcome : Results from the RECORd1 project. / Minervini, Andrea; Mari, Andrea; Borghesi, Marco; Antonelli, Alessandro; Bertolo, Riccardo; Bianchi, Giampaolo; Brunocilla, Eugenio; Ficarra, Vincenzo; Fiori, Cristian; Longo, Nicola; Mirone, Vincenzo; Morgia, Giuseppe; Porpiglia, Francesco; Rocco, Bernardo; Serni, Sergio; Simeone, Claudio; Tellini, Riccardo; Volpe, Alessandro; Carini, Marco; Schiavina, Riccardo.

In: Minerva Urologica e Nefrologica, Vol. 71, No. 1, 01.02.2019, p. 47-54.

Research output: Contribution to journalArticle

Minervini, A, Mari, A, Borghesi, M, Antonelli, A, Bertolo, R, Bianchi, G, Brunocilla, E, Ficarra, V, Fiori, C, Longo, N, Mirone, V, Morgia, G, Porpiglia, F, Rocco, B, Serni, S, Simeone, C, Tellini, R, Volpe, A, Carini, M & Schiavina, R 2019, 'The occurrence of intraoperative complications during partial nephrectomy and their impact on postoperative outcome: Results from the RECORd1 project', Minerva Urologica e Nefrologica, vol. 71, no. 1, pp. 47-54. https://doi.org/10.23736/S0393-2249.18.03202-2
Minervini, Andrea ; Mari, Andrea ; Borghesi, Marco ; Antonelli, Alessandro ; Bertolo, Riccardo ; Bianchi, Giampaolo ; Brunocilla, Eugenio ; Ficarra, Vincenzo ; Fiori, Cristian ; Longo, Nicola ; Mirone, Vincenzo ; Morgia, Giuseppe ; Porpiglia, Francesco ; Rocco, Bernardo ; Serni, Sergio ; Simeone, Claudio ; Tellini, Riccardo ; Volpe, Alessandro ; Carini, Marco ; Schiavina, Riccardo. / The occurrence of intraoperative complications during partial nephrectomy and their impact on postoperative outcome : Results from the RECORd1 project. In: Minerva Urologica e Nefrologica. 2019 ; Vol. 71, No. 1. pp. 47-54.
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abstract = "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.",
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AU - Minervini, Andrea

AU - Mari, Andrea

AU - Borghesi, Marco

AU - Antonelli, Alessandro

AU - Bertolo, Riccardo

AU - Bianchi, Giampaolo

AU - Brunocilla, Eugenio

AU - Ficarra, Vincenzo

AU - Fiori, Cristian

AU - Longo, Nicola

AU - Mirone, Vincenzo

AU - Morgia, Giuseppe

AU - Porpiglia, Francesco

AU - Rocco, Bernardo

AU - Serni, Sergio

AU - Simeone, Claudio

AU - Tellini, Riccardo

AU - Volpe, Alessandro

AU - Carini, Marco

AU - Schiavina, Riccardo

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N2 - 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.

AB - 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.

KW - Computer-assisted surgery

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KW - Laparoscopy

KW - Nephrectomy

KW - Robotics

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