title: Complications after robotic partial nephrectomy at centers of excellence: multi-institutional analysis of 450 cases.
abstract: OBJECTIVE
  We evaluated the incidence of perioperative complications after robotic partial nephrectomy.
  
  
  METHODS
  We retrospectively reviewed the records of patients treated with robotic assisted partial nephrectomy across the 4 participating institutions. Demographic, blood loss, warm ischemia time, and intraoperative and postoperative complication data were collected. All complications were graded according to the Clavien classification system.
  
  
  RESULTS
  A total of 450 consecutive robotic assisted partial nephrectomies were done between June 2006 and May 2009. Overall 71 patients (15.8%) had a complication, including intraoperative and postoperative complications in 8 (1.8%) and 65 (14.4%), respectively. Hemorrhage developed in 2 patients (0.2%) intraoperatively and in 22 (4.9%) postoperatively. Seven patients (1.6%) had urine leakage. As classified by the Clavien system, complications were grade I-II in 76.1% of cases and grade III-IV in 23.9%. Robotic assisted partial nephrectomy was converted to open or conventional laparoscopic surgery in 3 patients (0.7%) and to radical nephrectomy in 7 (1.6%). There were no deaths.
  
  
  CONCLUSIONS
  Current data indicate that robotic assisted partial nephrectomy is safe. Most postoperative complications are Clavien grade I or II, or can be managed conservatively.
authors.affiliation: Glickman Urological Institute Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Spana
authors.forename: Georges-Pascal
authors.initials: GP
authors.lastname: Haber
authors.forename: Lori M
authors.initials: LM
authors.lastname: Dulabon
authors.forename: Firas
authors.initials: F
authors.lastname: Petros
authors.forename: Craig G
authors.initials: CG
authors.lastname: Rogers
authors.forename: Sam B
authors.initials: SB
authors.lastname: Bhayani
authors.forename: Michael D
authors.initials: MD
authors.lastname: Stifelman
authors.forename: Jihad H
authors.initials: JH
authors.lastname: Kaouk
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D012371:Robotics; D055815:Young Adult