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Open versus mini-invasive partial and radical nephrectomy complications: results from the French national health database

  • 0Department of Urology, Nancy University Hospital, Vandoeuvre-lès-Nancy, 54500, France. g.pascal@chru-nancy.fr.
Bmc Urology +

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October 21, 2024

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October 21, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Laparoscopic kidney cancer surgery shows fewer complications and shorter hospital stays than open surgery. This French study analyzed 8,162 patients, confirming benefits for radical and partial nephrectomies.

Area Of Science

  • Urology
  • Surgical Oncology
  • Minimally Invasive Surgery

Background

  • Laparoscopic surgery generally offers lower morbidity compared to open procedures.
  • Recent comparative data on kidney cancer surgery in the French population using national health insurance data was lacking.

Purpose Of The Study

  • To compare surgical morbidity rates between laparoscopic and open laparotomy for kidney cancer.
  • To analyze postoperative complications and length of stay for different surgical approaches.

Main Methods

  • Retrospective analysis of 8,162 kidney cancer patients undergoing surgery in France in 2018, using the PMSI-MCO database.
  • Comparison of postoperative complications and length of stay between laparoscopic and open surgery for both radical and partial nephrectomies.
  • Calculation of Relative Risks (RR) with 95% Confidence Intervals (CI) for complication rates.

Main Results

  • Laparoscopic radical nephrectomy (2,547 patients) showed lower risks for urinary infections (RR 0.68), acute renal failure (RR 0.71), sepsis (RR 0.69), and postoperative anemia (RR 0.56) compared to open surgery (978 patients).
  • Laparoscopic partial nephrectomy (2,859 patients) demonstrated reduced risks for urinary infections (RR 0.71), bleeding (RR 0.61), and postoperative anemia (RR 0.64) versus open surgery (1,778 patients).
  • Mean length of stay was significantly shorter for laparoscopic procedures: 6.3 days (radical) and 5 days (partial) compared to 7.7 days (radical) and 7.5 days (partial) for open surgery.

Conclusions

  • The laparoscopic approach is associated with fewer postoperative complications and a shorter length of stay for both radical and partial nephrectomies compared to open surgery.
  • The PMSI-MCO database analysis provides a comprehensive overview of kidney cancer surgical practices and outcomes in France.

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