Complications of radical and partial nephrectomy in a large contemporary cohort.
OBJECTIVE
Standardized criteria for reporting the early complications of urological procedures are lacking. We reviewed the early complications of radical nephrectomy (RN) and partial nephrectomy (PN) in a large contemporary cohort using a standardized complication grading scale.


METHODS
Between 1995 and 2002, 1,049 patients underwent RN (66%) or PN (34%) for renal cortical neoplasm. Records were reviewed for perioperative complications. Complications were graded using a 5-tiered scale based on the severity of impact or intensity of therapy required.


RESULTS
A total of 235 complications occurred in 180 patients (17%). Overall 55% and 31% of complications were grade I and grade II, respectively. There were 3 perioperative deaths (0.2%). PN was not associated with more complications compared to RN when accounting for other variables. PN cases had more procedure related complications compared to RN (9% versus 3%, respectively, p = 0.0001) due to complications of urinary leak and the reintervention rate was subsequently higher (2.5% versus 0.6%, p = 0.02). All but 1 of the reinterventions for PN involved either endoscopy or radiology. By multivariate analysis operative time (p <0.0001) and solitary kidney (p = 0.06) were associated with procedure related complications of PN.


CONCLUSIONS
RN and PN are associated with low rates of serious morbidity and mortality. Compared to RN, PN is associated with higher rates of procedure related complications, the majority of which are minor. Overall, however, PN is not associated with more complications than RN.
Stephenson
Andrew J
AJ
Department of Urology, Sidney Kimmel Cancer Center for Prostate and Urologic Cancers, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Hakimi
A Ari
AA
Snyder
Mark E
ME
Russo
Paul
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D006801:Humans; D007672:Kidney Cortex; D007680:Kidney Neoplasms / Q000601:surgery; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D012720:Severity of Illness Index