[Complications of radical nephrectomy in the treatment of kidney adenocarcinoma].
OBJECTIVE
To evaluate the peri- and post-surgical complications in Renal Adenocarcinoma (RAC) treated with Radical Nephrectomy (RN).


METHODS
Revision of 109 patients with RAC who underwent transperitoneal anterior abdominal RN. Patients were locally staged post-surgically as: T1 + T2 61.5%, T3a 22.9%, T3ab 11% and T3b 4.6%. Approach and conservation of homolateral suprarenal gland were decided based on the preferences of the performing urologist. Hilar lymphadenectomy was performed in all cases. RN was done by a staff member in 77% cases and by a training resident assisted by a staff member in the remaining 23%.


RESULTS
Peri-operative complications occurred in 10% patients, most commonly with left RN (13% vs. 7%) (p = 0.1), and further within this group the most frequent ones occurred in those using midpoint laparotomy (17.8% vs. 4%) (p = 0.1). Blood transfusion during surgery was required in 23% patients, this being more frequent when tumours had extended into the venous system (47%) and in left RN by midpoint laparotomy (39% vs. 12.5%) (p = 0.02). There were 32 post-surgical complications in 27 (24.8%) patients, the most common being sepsis of the surgical wound (6.4%); complications were more usual in patients undergoing right RN (31% vs. 20%) (p = 0.08) and in patients with blood transfusions (40% vs. 20%) (p = 0.4). There were no deaths.


CONCLUSIONS
In our series, RN showed low intraoperative morbidity (10%), non-insignificant post-operative morbidity (24.8%) and no mortality. We consider subcostal laparotomy to be the best surgical approach in left RAC, with low morbidity and low peri-operative blood requirements.
Herranz Amo
F
F
Servicio de Urología, H.G.U., Gregorio Marañón, Universidad Complutense, Madrid.
Verdú Tartajo
F
F
Díez Cordero
J M
JM
Rodríguez Fernández
E
E
Lledó García
E
E
Moncada Iribarren
I
I
Jara Rascón
J
J
González Chamorro
F
F
de Palacio España
A
A
D000230:Adenocarcinoma / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D007431:Intraoperative Complications / Q000453:epidemiology / Q000209:etiology*; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies