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Postoperative Complications After Robotic Partial Nephrectomy.

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|October 8, 2019
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Summary
This summary is machine-generated.

Robotic partial nephrectomy (RPN) shows low rates of arterial malformation (AM) and urine leak (UL), decreasing with surgeon experience. These rare complications occur despite increasing surgical complexity in contemporary RPN series.

Keywords:
partial nephrectomypseudoaneurysmurine leak

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Nephrology

Background:

  • Robotic partial nephrectomy (RPN) is a standard procedure for renal tumors.
  • Postoperative complications like arterial malformation (AM) and urine leak (UL) can occur.
  • Assessing the incidence and risk factors for these specific complications is crucial for improving patient outcomes.

Purpose of the Study:

  • To determine the incidence of postoperative arterial malformation (AM) and urine leak/urinoma (UL) after robotic partial nephrectomy (RPN).
  • To identify potential risk factors associated with these specific complications.
  • To evaluate trends in AM and UL incidence in a contemporary RPN series.

Main Methods:

  • A retrospective and prospective review of 395 RPN cases performed between January 2014 and October 2018.
  • Data collected included demographics, perioperative variables, and postoperative complications graded by the Clavien-Dindo system.
  • Arterial malformation (AM) and urine leak (UL) were defined based on imaging and clinical criteria, with univariate analysis used to assess predictors.

Main Results:

  • The overall incidence of postoperative complications was 5.6% (5.3% retrospective, 5.8% prospective).
  • The incidence of AM was 2.3% (3.1% retrospective, 1.1% prospective), and UL was 0.25% (0.55% retrospective, 0.0% prospective).
  • No significant predictors for AM were identified, and complication rates decreased with experience despite increased tumor complexity.

Conclusions:

  • Postoperative complications, including AM and UL, after RPN remain infrequent.
  • The incidence of AM and UL appears to be decreasing in contemporary series, suggesting a learning curve effect.
  • RPN is a safe procedure with low rates of serious postoperative complications, even with complex cases.