Comparison of complications after radical and partial nephrectomy: results from the National Veterans Administration Surgical Quality Improvement Program
Objective To determine whether radical nephrectomy causes less morbidity, less mortality and is associated with a shorter hospital stay than is partial nephrectomy. Patients and methods A total of 1885 nephrectomies (1373 radical and 512 partial) conducted between 1991 and 1998 in the Department of...
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| Veröffentlicht in: | BJU international 2000-11, Vol.86 (7), p.782-789 |
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| creator | Corman, J.M. Penson, D.F. Hur, K. Khuri, S.F. Daley, J. Henderson, W. Krieger, J.N. |
| description | Objective To determine whether radical nephrectomy causes less morbidity, less mortality and is associated with a shorter hospital stay than is partial nephrectomy.
Patients and methods A total of 1885 nephrectomies (1373 radical and 512 partial) conducted between 1991 and 1998 in the Department of Veterans Affairs (VA) National Surgical Quality Improvement Program were evaluated. Using multivariate analyses, outcomes were risk‐adjusted based on 45 preoperative variables to compare mortality and morbidity rates.
Results The unadjusted 30‐day mortality was 2.0% for radical and 1.6% for partial nephrectomy (P = 0.58). Risk‐adjusting the two groups did not result in a statistically significant difference in mortality. The 30‐day overall morbidity rate was 15% for radical and 16.2% for partial nephrectomy (P = 0.52); risk‐adjusted morbidity rates were not statistically different. There were no statistically significant differences in the rates of postoperative progressive renal failure, acute renal failure, urinary tract infection, prolonged ileus, transfusion requirement, deep wound infection, or extended length of stay.
Conclusions Partial nephrectomy carried out in the VA program has low morbidity and mortality rates, comparable with the complication rates after radical nephrectomy. |
| doi_str_mv | 10.1046/j.1464-410x.2000.00919.x |
| format | Article |
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Patients and methods A total of 1885 nephrectomies (1373 radical and 512 partial) conducted between 1991 and 1998 in the Department of Veterans Affairs (VA) National Surgical Quality Improvement Program were evaluated. Using multivariate analyses, outcomes were risk‐adjusted based on 45 preoperative variables to compare mortality and morbidity rates.
Results The unadjusted 30‐day mortality was 2.0% for radical and 1.6% for partial nephrectomy (P = 0.58). Risk‐adjusting the two groups did not result in a statistically significant difference in mortality. The 30‐day overall morbidity rate was 15% for radical and 16.2% for partial nephrectomy (P = 0.52); risk‐adjusted morbidity rates were not statistically different. There were no statistically significant differences in the rates of postoperative progressive renal failure, acute renal failure, urinary tract infection, prolonged ileus, transfusion requirement, deep wound infection, or extended length of stay.
Conclusions Partial nephrectomy carried out in the VA program has low morbidity and mortality rates, comparable with the complication rates after radical nephrectomy.</description><identifier>ISSN: 1464-4096</identifier><identifier>EISSN: 1464-410X</identifier><identifier>DOI: 10.1046/j.1464-410x.2000.00919.x</identifier><identifier>PMID: 11069401</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Science Ltd</publisher><subject>Biological and medical sciences ; Carcinoma, Renal Cell - surgery ; Female ; Humans ; Kidney Neoplasms - surgery ; Length of Stay ; Logistic Models ; Male ; Medical sciences ; morbidity ; mortality ; Multivariate Analysis ; Nephrectomy - adverse effects ; Nephrectomy - methods ; Nephrectomy - mortality ; partial nephrectomy ; Prospective Studies ; radical nephrectomy ; renal cell carcinoma ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the urinary system</subject><ispartof>BJU international, 2000-11, Vol.86 (7), p.782-789</ispartof><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3939-b1b3481a88fddc23d2cfa63e7bf366eda01efdb8fa06fcfb25d5333f81d6897e3</citedby><cites>FETCH-LOGICAL-c3939-b1b3481a88fddc23d2cfa63e7bf366eda01efdb8fa06fcfb25d5333f81d6897e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1046%2Fj.1464-410x.2000.00919.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1046%2Fj.1464-410x.2000.00919.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1008537$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11069401$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Corman, J.M.</creatorcontrib><creatorcontrib>Penson, D.F.</creatorcontrib><creatorcontrib>Hur, K.</creatorcontrib><creatorcontrib>Khuri, S.F.</creatorcontrib><creatorcontrib>Daley, J.</creatorcontrib><creatorcontrib>Henderson, W.</creatorcontrib><creatorcontrib>Krieger, J.N.</creatorcontrib><title>Comparison of complications after radical and partial nephrectomy: results from the National Veterans Administration Surgical Quality Improvement Program</title><title>BJU international</title><addtitle>BJU Int</addtitle><description>Objective To determine whether radical nephrectomy causes less morbidity, less mortality and is associated with a shorter hospital stay than is partial nephrectomy.
Patients and methods A total of 1885 nephrectomies (1373 radical and 512 partial) conducted between 1991 and 1998 in the Department of Veterans Affairs (VA) National Surgical Quality Improvement Program were evaluated. Using multivariate analyses, outcomes were risk‐adjusted based on 45 preoperative variables to compare mortality and morbidity rates.
Results The unadjusted 30‐day mortality was 2.0% for radical and 1.6% for partial nephrectomy (P = 0.58). Risk‐adjusting the two groups did not result in a statistically significant difference in mortality. The 30‐day overall morbidity rate was 15% for radical and 16.2% for partial nephrectomy (P = 0.52); risk‐adjusted morbidity rates were not statistically different. There were no statistically significant differences in the rates of postoperative progressive renal failure, acute renal failure, urinary tract infection, prolonged ileus, transfusion requirement, deep wound infection, or extended length of stay.
Conclusions Partial nephrectomy carried out in the VA program has low morbidity and mortality rates, comparable with the complication rates after radical nephrectomy.</description><subject>Biological and medical sciences</subject><subject>Carcinoma, Renal Cell - surgery</subject><subject>Female</subject><subject>Humans</subject><subject>Kidney Neoplasms - surgery</subject><subject>Length of Stay</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>morbidity</subject><subject>mortality</subject><subject>Multivariate Analysis</subject><subject>Nephrectomy - adverse effects</subject><subject>Nephrectomy - methods</subject><subject>Nephrectomy - mortality</subject><subject>partial nephrectomy</subject><subject>Prospective Studies</subject><subject>radical nephrectomy</subject><subject>renal cell carcinoma</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the urinary system</subject><issn>1464-4096</issn><issn>1464-410X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkctuFDEQRS0EIiHwC8gLxG6acrvH043YJCMeQREPQRA7y22XE4_a7cF2w8yn8Ld4HhEsWblcdepWqS4hlEHFoBEvVhVrRDNrGGyqGgAqgI511eYeOb0rfL9_F0MnTsijlFYAJSHmD8kJYyC6Btgp-b0Mfq2iS2GkwVJdfoPTKrswJqpsxkijMiUzUDUaWtDsSjzi-jaizsFvX9KIaRpyojYGT_Mt0g_7_oJ9wyKgitK58W50Kcd9hX6Z4s1e8_OkBpe39NKvY_iJHsdMP8VwE5V_TB5YNSR8cnzPyPWb11-X72ZXH99eLs-vZpp3vJv1rOdNy1TbWmN0zU2trRIcF73lQqBRwNCavrUKhNW2r-dmzjm3LTOi7RbIz8jzg27Z4MeEKUvvksZhUCOGKclF3UBTi7qA7QHUMaQU0cp1dF7FrWQgd7bIldxdXO5skTtb5N4WuSmtT48zpt6j-dt49KEAz46ASuUuthxNu_TPAGjnfFGwVwfslxtw-9_z5cX76xLwP5_Rrj4</recordid><startdate>200011</startdate><enddate>200011</enddate><creator>Corman, J.M.</creator><creator>Penson, D.F.</creator><creator>Hur, K.</creator><creator>Khuri, S.F.</creator><creator>Daley, J.</creator><creator>Henderson, W.</creator><creator>Krieger, J.N.</creator><general>Blackwell Science Ltd</general><general>Blackwell</general><scope>IQODW</scope><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>200011</creationdate><title>Comparison of complications after radical and partial nephrectomy: results from the National Veterans Administration Surgical Quality Improvement Program</title><author>Corman, J.M. ; Penson, D.F. ; Hur, K. ; Khuri, S.F. ; Daley, J. ; Henderson, W. ; Krieger, J.N.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3939-b1b3481a88fddc23d2cfa63e7bf366eda01efdb8fa06fcfb25d5333f81d6897e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Biological and medical sciences</topic><topic>Carcinoma, Renal Cell - surgery</topic><topic>Female</topic><topic>Humans</topic><topic>Kidney Neoplasms - surgery</topic><topic>Length of Stay</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>morbidity</topic><topic>mortality</topic><topic>Multivariate Analysis</topic><topic>Nephrectomy - adverse effects</topic><topic>Nephrectomy - methods</topic><topic>Nephrectomy - mortality</topic><topic>partial nephrectomy</topic><topic>Prospective Studies</topic><topic>radical nephrectomy</topic><topic>renal cell carcinoma</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the urinary system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Corman, J.M.</creatorcontrib><creatorcontrib>Penson, D.F.</creatorcontrib><creatorcontrib>Hur, K.</creatorcontrib><creatorcontrib>Khuri, S.F.</creatorcontrib><creatorcontrib>Daley, J.</creatorcontrib><creatorcontrib>Henderson, W.</creatorcontrib><creatorcontrib>Krieger, J.N.</creatorcontrib><collection>Pascal-Francis</collection><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>BJU international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Corman, J.M.</au><au>Penson, D.F.</au><au>Hur, K.</au><au>Khuri, S.F.</au><au>Daley, J.</au><au>Henderson, W.</au><au>Krieger, J.N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of complications after radical and partial nephrectomy: results from the National Veterans Administration Surgical Quality Improvement Program</atitle><jtitle>BJU international</jtitle><addtitle>BJU Int</addtitle><date>2000-11</date><risdate>2000</risdate><volume>86</volume><issue>7</issue><spage>782</spage><epage>789</epage><pages>782-789</pages><issn>1464-4096</issn><eissn>1464-410X</eissn><abstract>Objective To determine whether radical nephrectomy causes less morbidity, less mortality and is associated with a shorter hospital stay than is partial nephrectomy.
Patients and methods A total of 1885 nephrectomies (1373 radical and 512 partial) conducted between 1991 and 1998 in the Department of Veterans Affairs (VA) National Surgical Quality Improvement Program were evaluated. Using multivariate analyses, outcomes were risk‐adjusted based on 45 preoperative variables to compare mortality and morbidity rates.
Results The unadjusted 30‐day mortality was 2.0% for radical and 1.6% for partial nephrectomy (P = 0.58). Risk‐adjusting the two groups did not result in a statistically significant difference in mortality. The 30‐day overall morbidity rate was 15% for radical and 16.2% for partial nephrectomy (P = 0.52); risk‐adjusted morbidity rates were not statistically different. There were no statistically significant differences in the rates of postoperative progressive renal failure, acute renal failure, urinary tract infection, prolonged ileus, transfusion requirement, deep wound infection, or extended length of stay.
Conclusions Partial nephrectomy carried out in the VA program has low morbidity and mortality rates, comparable with the complication rates after radical nephrectomy.</abstract><cop>Oxford, UK</cop><pub>Blackwell Science Ltd</pub><pmid>11069401</pmid><doi>10.1046/j.1464-410x.2000.00919.x</doi><tpages>8</tpages></addata></record> |
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| subjects | Biological and medical sciences Carcinoma, Renal Cell - surgery Female Humans Kidney Neoplasms - surgery Length of Stay Logistic Models Male Medical sciences morbidity mortality Multivariate Analysis Nephrectomy - adverse effects Nephrectomy - methods Nephrectomy - mortality partial nephrectomy Prospective Studies radical nephrectomy renal cell carcinoma Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system |
| title | Comparison of complications after radical and partial nephrectomy: results from the National Veterans Administration Surgical Quality Improvement Program |
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