Nephron-Sparing Surgery for Renal Cell Carcinoma: Detailed Analysis of Complications Over a 15-Year Period

To assess the incidence of complications of conservative renal surgery for renal cell carcinoma in both elective and imperative indications, and its evolution over a 15 year period. From 1988 to 2003, 127 patients underwent partial nephrectomy or tumorectomy for renal cell carcinoma in our department. Indications were imperative in 42% (n=53) and elective in 58% (n=74) of cases. Morbidity was retrospectively assessed according to four parameters: 1- Period of surgery: A, from 1988 to 1999 and B, from 2000 to 2003. 2- Indication: elective vs. imperative. 3- experience of surgeon: senior vs. junior. 4- Nature of complications: minor or major. Comparative analysis was conducted using Chi-square and Fischer exact tests. Global incidence of complications was 30.7% (n=39) corresponding to 18.1% minor (n=23) and 12.6% (n=16) major complications. Results show a moderate decrease of complication rate during Period B: 28.1% versus 32.9% during period A (p=0.69). Complications occurred more frequently in imperative indications (49.1%) than in elective indications (17.6%) (p=0.002), mostly regarding major complications (respectively 28.3% and 1.4%. (p