OBJECTIVES: To examine the effect of surgical approach on perioperative morbidity and mortality after partial nephrectomy.
MATERIALS AND METHODS: Within the Nationwide Inpatient Sample, patients who underwent RAPN or LPN between October 2008 and December 2009 were identified. Propensity-based matching was performed to adjust for potential baseline differences between the two groups. The rates of intraoperative and postoperative complications, blood transfusions, prolonged length of stay, and in-hospital mortality, stratified according to RAPN vs. LPN, were compared.
RESULTS: Overall, 851 (72.5%) patients underwent RAPN and 323 (27.5%) underwent LPN. For RAPN and LPN respectively, the following rates were recorded in the propensity-score matched cohort: blood transfusions, 4.5 vs. 6.8% (p = 0.223); intraoperative complications, 5.2 vs. 2.6% (p = 0.096); postoperative complications, 10.6 vs. 13.5% (p = 0.268); prolonged length of stay, 6.8 vs. 9.4% (p = 0.238); in-hospital mortality, 0.0 vs. 0.0%.
CONCLUSIONS: RAPN has supplanted LPN as the predominant minimally invasive surgical approach for renal masses. Perioperative outcomes after RAPN and LPN are comparable. Interpretation of these findings needs to take into account the lack of adjustment for case complexity and surgical expertise.
Written by:
Sammon JD1, Karakiewicz PI, Sun M, Ravi P, Ghani KR, Jeong W, Bianchi M, Hansen J, Perrotte P, Peabody JO, Rogers CG, Shariat SF, Menon M, Trinh QD Are you the author?
1Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI 48202, USA.
Reference: Int Braz J Urol. 2013 May-Jun;39(3):377-86
doi: 10.1590/S1677-5538.IBJU.2013.03.11
PubMed Abstract
PMID: 23849569
UroToday.com Renal Cancer Section
