Not so simple nephrectomy: Comparative analysis of radical and simple nephrectomy in a high-volume tertiary referral centre
BAUS ePoster online library. Papadopoulou A. 06/23/21; 319037; p12-9
Disclosure(s): The authors have no funds to report. The authors have no conflicts of interest.
Ms. Ariadni Papadopoulou
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Introduction: The term 'simple' nephrectomy is controversial as surgery for benign pathology is technically challenging and may be associated with higher complication rates. We compared patient characteristics, intraoperative and postoperative outcomes between simple (SN) and radical nephrectomy (RN) in a single, high volume tertiary referral center.
Patients & methods: A prospective patient database was interrogated for RN and SN patient demographics, intra and post-operative outcomes and complications (January 2016-October 2020). RN were classified as: Group-1(cT1), Group-2(cT2a) and Group-3(tumour size > 10 cm) and compared to SN. Subgroup analysis was performed for minimally invasive (MI), open approach and infected vs. non infected SN pathology utilizing Mann Whitney U, Chi-squared and Mantel-Haenszel test.
Results: 344 RN and 130 SN were included. Patients in the SN group experienced a longer operative time(p=0.023) and more postoperative complications(P=0.006). MI SN(125/131) entailed significantly higher operative time(P=0.010), length of stay(P=0.028) and post-op complications(P<0.001) than MI RN. SN had significantly higher operative time(P<0.001), length of stay(P=0.014), and post-operative morbidity(P<0.001) than cT1 RN and significantly more Clavien 1-2 complications than cT2a RN(P=0.001). Infected SN(50/130) required longer operative time(P<0.001), length of stay(P=0.005) and intensive care unit admissions(P=0.019) than non-infected SN.
Conclusion: SN carry significant morbidity (complications, readmissions, longer inpatient stay) compared to RN regardless of surgical experience. Despite robotic interphase use, operative time and overall complications are significantly higher in SN. SN relates to higher morbidity compared to RN even in tumours up to 7-10 cm. These outcomes favor change of the designation from 'simple nephrectomy' to benign nephrectomy.
Patients & methods: A prospective patient database was interrogated for RN and SN patient demographics, intra and post-operative outcomes and complications (January 2016-October 2020). RN were classified as: Group-1(cT1), Group-2(cT2a) and Group-3(tumour size > 10 cm) and compared to SN. Subgroup analysis was performed for minimally invasive (MI), open approach and infected vs. non infected SN pathology utilizing Mann Whitney U, Chi-squared and Mantel-Haenszel test.
Results: 344 RN and 130 SN were included. Patients in the SN group experienced a longer operative time(p=0.023) and more postoperative complications(P=0.006). MI SN(125/131) entailed significantly higher operative time(P=0.010), length of stay(P=0.028) and post-op complications(P<0.001) than MI RN. SN had significantly higher operative time(P<0.001), length of stay(P=0.014), and post-operative morbidity(P<0.001) than cT1 RN and significantly more Clavien 1-2 complications than cT2a RN(P=0.001). Infected SN(50/130) required longer operative time(P<0.001), length of stay(P=0.005) and intensive care unit admissions(P=0.019) than non-infected SN.
Conclusion: SN carry significant morbidity (complications, readmissions, longer inpatient stay) compared to RN regardless of surgical experience. Despite robotic interphase use, operative time and overall complications are significantly higher in SN. SN relates to higher morbidity compared to RN even in tumours up to 7-10 cm. These outcomes favor change of the designation from 'simple nephrectomy' to benign nephrectomy.
Introduction: The term 'simple' nephrectomy is controversial as surgery for benign pathology is technically challenging and may be associated with higher complication rates. We compared patient characteristics, intraoperative and postoperative outcomes between simple (SN) and radical nephrectomy (RN) in a single, high volume tertiary referral center.
Patients & methods: A prospective patient database was interrogated for RN and SN patient demographics, intra and post-operative outcomes and complications (January 2016-October 2020). RN were classified as: Group-1(cT1), Group-2(cT2a) and Group-3(tumour size > 10 cm) and compared to SN. Subgroup analysis was performed for minimally invasive (MI), open approach and infected vs. non infected SN pathology utilizing Mann Whitney U, Chi-squared and Mantel-Haenszel test.
Results: 344 RN and 130 SN were included. Patients in the SN group experienced a longer operative time(p=0.023) and more postoperative complications(P=0.006). MI SN(125/131) entailed significantly higher operative time(P=0.010), length of stay(P=0.028) and post-op complications(P<0.001) than MI RN. SN had significantly higher operative time(P<0.001), length of stay(P=0.014), and post-operative morbidity(P<0.001) than cT1 RN and significantly more Clavien 1-2 complications than cT2a RN(P=0.001). Infected SN(50/130) required longer operative time(P<0.001), length of stay(P=0.005) and intensive care unit admissions(P=0.019) than non-infected SN.
Conclusion: SN carry significant morbidity (complications, readmissions, longer inpatient stay) compared to RN regardless of surgical experience. Despite robotic interphase use, operative time and overall complications are significantly higher in SN. SN relates to higher morbidity compared to RN even in tumours up to 7-10 cm. These outcomes favor change of the designation from 'simple nephrectomy' to benign nephrectomy.
Patients & methods: A prospective patient database was interrogated for RN and SN patient demographics, intra and post-operative outcomes and complications (January 2016-October 2020). RN were classified as: Group-1(cT1), Group-2(cT2a) and Group-3(tumour size > 10 cm) and compared to SN. Subgroup analysis was performed for minimally invasive (MI), open approach and infected vs. non infected SN pathology utilizing Mann Whitney U, Chi-squared and Mantel-Haenszel test.
Results: 344 RN and 130 SN were included. Patients in the SN group experienced a longer operative time(p=0.023) and more postoperative complications(P=0.006). MI SN(125/131) entailed significantly higher operative time(P=0.010), length of stay(P=0.028) and post-op complications(P<0.001) than MI RN. SN had significantly higher operative time(P<0.001), length of stay(P=0.014), and post-operative morbidity(P<0.001) than cT1 RN and significantly more Clavien 1-2 complications than cT2a RN(P=0.001). Infected SN(50/130) required longer operative time(P<0.001), length of stay(P=0.005) and intensive care unit admissions(P=0.019) than non-infected SN.
Conclusion: SN carry significant morbidity (complications, readmissions, longer inpatient stay) compared to RN regardless of surgical experience. Despite robotic interphase use, operative time and overall complications are significantly higher in SN. SN relates to higher morbidity compared to RN even in tumours up to 7-10 cm. These outcomes favor change of the designation from 'simple nephrectomy' to benign nephrectomy.
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