Postoperative Complications After Robotic Partial Nephrectomy
To assess the incidence of postoperative arterial malformation (AM) and urine leak/urinoma (UL) after robotic partial nephrectomy (RPN) in a contemporary series and to evaluate risk factors for these complications. All RPNs were queried from Institutional Review Board-approved retrospective and pros...
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| Veröffentlicht in: | Journal of endourology 2020-01, Vol.34 (1), p.42-47 |
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| creator | Connor, Jessica Doppalapudi, Sai K Wajswol, Ethan Ragam, Radhika Press, Benjamin Luu, Thaiphi Koster, Helaine Tamang, Tenzin-Lama Ahmed, Mutahar Lovallo, Gregory Munver, Ravi Stifelman, Michael D |
| description | To assess the incidence of postoperative arterial malformation (AM) and urine leak/urinoma (UL) after robotic partial nephrectomy (RPN) in a contemporary series and to evaluate risk factors for these complications.
All RPNs were queried from Institutional Review Board-approved retrospective and prospective nephrectomy databases. Demographics, perioperative variables, and postoperative complications were collected. Differences between cohorts were analyzed using univariate analysis. Postoperative complications were graded using the Clavien-Dindo system. UL was defined in the context of signs and symptoms of a collection with supporting evidence of urine collection through drainage or aspiration. AM was identified based on postoperative imaging indicative of arteriovenous fistula or pseudoaneurysm and/or requirement for selective embolization. Predictors of AM and UL were assessed by univariate analysis.
A total of 395 RPNs were performed by four urologists between January 2014 and October 2018. Tumor complexity, defined by nephrometry score, was significantly greater in the prospective cohort (
= 0.01). Overall incidence of postoperative complications was 5.6% with cohort-specific incidences of 5.3% and 5.8%. The retrospective cohort had a greater percentage of complications classified as ≥IIIa: 8/13 (61.5%)
2/8 (25%). Overall incidence of AM was 2.3% with cohort-specific incidence of 3.1% (7/225)
1.1% (2/170). Overall incidence of UL was 0.25% with cohort-specific incidence of 0.55% (1/225) and 0.0% (0/170). The difference in incidence of both complications between cohorts was significant (
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| doi_str_mv | 10.1089/end.2019.0434 |
| format | Article |
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All RPNs were queried from Institutional Review Board-approved retrospective and prospective nephrectomy databases. Demographics, perioperative variables, and postoperative complications were collected. Differences between cohorts were analyzed using univariate analysis. Postoperative complications were graded using the Clavien-Dindo system. UL was defined in the context of signs and symptoms of a collection with supporting evidence of urine collection through drainage or aspiration. AM was identified based on postoperative imaging indicative of arteriovenous fistula or pseudoaneurysm and/or requirement for selective embolization. Predictors of AM and UL were assessed by univariate analysis.
A total of 395 RPNs were performed by four urologists between January 2014 and October 2018. Tumor complexity, defined by nephrometry score, was significantly greater in the prospective cohort (
= 0.01). Overall incidence of postoperative complications was 5.6% with cohort-specific incidences of 5.3% and 5.8%. The retrospective cohort had a greater percentage of complications classified as ≥IIIa: 8/13 (61.5%)
2/8 (25%). Overall incidence of AM was 2.3% with cohort-specific incidence of 3.1% (7/225)
1.1% (2/170). Overall incidence of UL was 0.25% with cohort-specific incidence of 0.55% (1/225) and 0.0% (0/170). The difference in incidence of both complications between cohorts was significant (
< 0.05). No significant predictors for AM were identified.
The incidence of postoperative complications after RPN remains low (5.3%
5.8%, overall: 5.6%). UL and AM are becoming rarer with experience, despite increasing surgical complexity (0.55%
0%, 3.1%
1.1%).</description><identifier>ISSN: 0892-7790</identifier><identifier>EISSN: 1557-900X</identifier><identifier>DOI: 10.1089/end.2019.0434</identifier><identifier>PMID: 31588795</identifier><language>eng</language><publisher>United States</publisher><subject>Aged ; Databases, Factual ; Female ; Humans ; Incidence ; Kidney Neoplasms - surgery ; Male ; Middle Aged ; Nephrectomy - adverse effects ; Nephrectomy - methods ; Postoperative Complications - epidemiology ; Prospective Studies ; Retrospective Studies ; Risk Factors ; Robotic Surgical Procedures - adverse effects ; Robotic Surgical Procedures - methods ; Treatment Outcome ; Urinoma - epidemiology ; Urinoma - etiology</subject><ispartof>Journal of endourology, 2020-01, Vol.34 (1), p.42-47</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c293t-cafa50b1f5f9d9ee0b11332a798059f76aadec9684e71b316219064e963f55a63</citedby><cites>FETCH-LOGICAL-c293t-cafa50b1f5f9d9ee0b11332a798059f76aadec9684e71b316219064e963f55a63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31588795$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Connor, Jessica</creatorcontrib><creatorcontrib>Doppalapudi, Sai K</creatorcontrib><creatorcontrib>Wajswol, Ethan</creatorcontrib><creatorcontrib>Ragam, Radhika</creatorcontrib><creatorcontrib>Press, Benjamin</creatorcontrib><creatorcontrib>Luu, Thaiphi</creatorcontrib><creatorcontrib>Koster, Helaine</creatorcontrib><creatorcontrib>Tamang, Tenzin-Lama</creatorcontrib><creatorcontrib>Ahmed, Mutahar</creatorcontrib><creatorcontrib>Lovallo, Gregory</creatorcontrib><creatorcontrib>Munver, Ravi</creatorcontrib><creatorcontrib>Stifelman, Michael D</creatorcontrib><title>Postoperative Complications After Robotic Partial Nephrectomy</title><title>Journal of endourology</title><addtitle>J Endourol</addtitle><description>To assess the incidence of postoperative arterial malformation (AM) and urine leak/urinoma (UL) after robotic partial nephrectomy (RPN) in a contemporary series and to evaluate risk factors for these complications.
All RPNs were queried from Institutional Review Board-approved retrospective and prospective nephrectomy databases. Demographics, perioperative variables, and postoperative complications were collected. Differences between cohorts were analyzed using univariate analysis. Postoperative complications were graded using the Clavien-Dindo system. UL was defined in the context of signs and symptoms of a collection with supporting evidence of urine collection through drainage or aspiration. AM was identified based on postoperative imaging indicative of arteriovenous fistula or pseudoaneurysm and/or requirement for selective embolization. Predictors of AM and UL were assessed by univariate analysis.
A total of 395 RPNs were performed by four urologists between January 2014 and October 2018. Tumor complexity, defined by nephrometry score, was significantly greater in the prospective cohort (
= 0.01). Overall incidence of postoperative complications was 5.6% with cohort-specific incidences of 5.3% and 5.8%. The retrospective cohort had a greater percentage of complications classified as ≥IIIa: 8/13 (61.5%)
2/8 (25%). Overall incidence of AM was 2.3% with cohort-specific incidence of 3.1% (7/225)
1.1% (2/170). Overall incidence of UL was 0.25% with cohort-specific incidence of 0.55% (1/225) and 0.0% (0/170). The difference in incidence of both complications between cohorts was significant (
< 0.05). No significant predictors for AM were identified.
The incidence of postoperative complications after RPN remains low (5.3%
5.8%, overall: 5.6%). UL and AM are becoming rarer with experience, despite increasing surgical complexity (0.55%
0%, 3.1%
1.1%).</description><subject>Aged</subject><subject>Databases, Factual</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Kidney Neoplasms - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nephrectomy - adverse effects</subject><subject>Nephrectomy - methods</subject><subject>Postoperative Complications - epidemiology</subject><subject>Prospective Studies</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Robotic Surgical Procedures - adverse effects</subject><subject>Robotic Surgical Procedures - methods</subject><subject>Treatment Outcome</subject><subject>Urinoma - epidemiology</subject><subject>Urinoma - etiology</subject><issn>0892-7790</issn><issn>1557-900X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kM9LwzAYhoMobk6PXqVHL535mqZpDh7G8BcMHaLgLaTpF6y0S01SYf-9HZue3u_le3gPDyGXQOdAS3mDm3qeUZBzmrP8iEyBc5FKSj-OyXT8Z6kQkk7IWQhflAIrgJ2SCQNelkLyKblduxBdj17H5geTpev6tjFjcZuQLGxEn7y6ysXGJGvtY6Pb5Bn7T48mum57Tk6sbgNeHHJG3u_v3paP6erl4Wm5WKUmkyymRlvNaQWWW1lLxPEExjItZEm5tKLQukYjizJHARWDIgNJixxlwSznumAzcr3f7b37HjBE1TXBYNvqDbohqIxRKMtMChjRdI8a70LwaFXvm077rQKqdsbUaEztjKmdsZG_OkwPVYf1P_2niP0CjS5myw</recordid><startdate>202001</startdate><enddate>202001</enddate><creator>Connor, Jessica</creator><creator>Doppalapudi, Sai K</creator><creator>Wajswol, Ethan</creator><creator>Ragam, Radhika</creator><creator>Press, Benjamin</creator><creator>Luu, Thaiphi</creator><creator>Koster, Helaine</creator><creator>Tamang, Tenzin-Lama</creator><creator>Ahmed, Mutahar</creator><creator>Lovallo, Gregory</creator><creator>Munver, Ravi</creator><creator>Stifelman, Michael D</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202001</creationdate><title>Postoperative Complications After Robotic Partial Nephrectomy</title><author>Connor, Jessica ; Doppalapudi, Sai K ; Wajswol, Ethan ; Ragam, Radhika ; Press, Benjamin ; Luu, Thaiphi ; Koster, Helaine ; Tamang, Tenzin-Lama ; Ahmed, Mutahar ; Lovallo, Gregory ; Munver, Ravi ; Stifelman, Michael D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c293t-cafa50b1f5f9d9ee0b11332a798059f76aadec9684e71b316219064e963f55a63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Databases, Factual</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Kidney Neoplasms - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nephrectomy - adverse effects</topic><topic>Nephrectomy - methods</topic><topic>Postoperative Complications - epidemiology</topic><topic>Prospective Studies</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Robotic Surgical Procedures - adverse effects</topic><topic>Robotic Surgical Procedures - methods</topic><topic>Treatment Outcome</topic><topic>Urinoma - epidemiology</topic><topic>Urinoma - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Connor, Jessica</creatorcontrib><creatorcontrib>Doppalapudi, Sai K</creatorcontrib><creatorcontrib>Wajswol, Ethan</creatorcontrib><creatorcontrib>Ragam, Radhika</creatorcontrib><creatorcontrib>Press, Benjamin</creatorcontrib><creatorcontrib>Luu, Thaiphi</creatorcontrib><creatorcontrib>Koster, Helaine</creatorcontrib><creatorcontrib>Tamang, Tenzin-Lama</creatorcontrib><creatorcontrib>Ahmed, Mutahar</creatorcontrib><creatorcontrib>Lovallo, Gregory</creatorcontrib><creatorcontrib>Munver, Ravi</creatorcontrib><creatorcontrib>Stifelman, Michael D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of endourology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Connor, Jessica</au><au>Doppalapudi, Sai K</au><au>Wajswol, Ethan</au><au>Ragam, Radhika</au><au>Press, Benjamin</au><au>Luu, Thaiphi</au><au>Koster, Helaine</au><au>Tamang, Tenzin-Lama</au><au>Ahmed, Mutahar</au><au>Lovallo, Gregory</au><au>Munver, Ravi</au><au>Stifelman, Michael D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Postoperative Complications After Robotic Partial Nephrectomy</atitle><jtitle>Journal of endourology</jtitle><addtitle>J Endourol</addtitle><date>2020-01</date><risdate>2020</risdate><volume>34</volume><issue>1</issue><spage>42</spage><epage>47</epage><pages>42-47</pages><issn>0892-7790</issn><eissn>1557-900X</eissn><abstract>To assess the incidence of postoperative arterial malformation (AM) and urine leak/urinoma (UL) after robotic partial nephrectomy (RPN) in a contemporary series and to evaluate risk factors for these complications.
All RPNs were queried from Institutional Review Board-approved retrospective and prospective nephrectomy databases. Demographics, perioperative variables, and postoperative complications were collected. Differences between cohorts were analyzed using univariate analysis. Postoperative complications were graded using the Clavien-Dindo system. UL was defined in the context of signs and symptoms of a collection with supporting evidence of urine collection through drainage or aspiration. AM was identified based on postoperative imaging indicative of arteriovenous fistula or pseudoaneurysm and/or requirement for selective embolization. Predictors of AM and UL were assessed by univariate analysis.
A total of 395 RPNs were performed by four urologists between January 2014 and October 2018. Tumor complexity, defined by nephrometry score, was significantly greater in the prospective cohort (
= 0.01). Overall incidence of postoperative complications was 5.6% with cohort-specific incidences of 5.3% and 5.8%. The retrospective cohort had a greater percentage of complications classified as ≥IIIa: 8/13 (61.5%)
2/8 (25%). Overall incidence of AM was 2.3% with cohort-specific incidence of 3.1% (7/225)
1.1% (2/170). Overall incidence of UL was 0.25% with cohort-specific incidence of 0.55% (1/225) and 0.0% (0/170). The difference in incidence of both complications between cohorts was significant (
< 0.05). No significant predictors for AM were identified.
The incidence of postoperative complications after RPN remains low (5.3%
5.8%, overall: 5.6%). UL and AM are becoming rarer with experience, despite increasing surgical complexity (0.55%
0%, 3.1%
1.1%).</abstract><cop>United States</cop><pmid>31588795</pmid><doi>10.1089/end.2019.0434</doi><tpages>6</tpages></addata></record> |
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| subjects | Aged Databases, Factual Female Humans Incidence Kidney Neoplasms - surgery Male Middle Aged Nephrectomy - adverse effects Nephrectomy - methods Postoperative Complications - epidemiology Prospective Studies Retrospective Studies Risk Factors Robotic Surgical Procedures - adverse effects Robotic Surgical Procedures - methods Treatment Outcome Urinoma - epidemiology Urinoma - etiology |
| title | Postoperative Complications After Robotic Partial Nephrectomy |
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