Laparoscopic and open partial nephrectomy: Complication comparison using the Clavien system

Jennifer E. Reifsnyder, Ranjith Ramasamy, Casey K. Ng, James DiPietro, Benjamin Shin, Shahrokh F. Shariat, Joseph J. Del Pizzo, Douglas S. Scherr

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Background and Objectives: To compare postoperative complications in patients undergoing laparoscopic and open partial nephrectomy using a standardized complication- reporting system and a standardized tumor-scoring system. Methods: We conducted a retrospective analysis of 189 consecutive patients with nephrometry scores available who underwent elective partial nephrectomy for renal masses. Demographic, perioperative, and complication data were recorded. By using the modified Clavien scale, we graded 30- and 90-day complication rates. Results: 107 patients underwent laparoscopic partial nephrectomy and 82 underwent open partial nephrectomy (N=189). Open partial nephrectomy patients had higher nephrometry scores than laparoscopic patients had (7.1±2.4 vs. 5.6±1.8, P<.001). Surgical and hospitalization times were shorter, and estimated blood loss was lower in the laparoscopic group (P<.001). At 30 days, there were more overall complications in the open group, but more major complications in the laparoscopic group (P>.05). After multivariable logistic regression analysis, only higher body mass index and higher estimated blood loss were predictors of more overall complications. Conclusions: Laparoscopic partial nephrectomy has the advantages of decreased operative time, lower blood loss, and shorter hospital stay. The complication rate in the laparoscopic group is similar to that in the open group, despite favorable tumor characteristics in the laparoscopic group.

Original languageEnglish (US)
Pages (from-to)38-44
Number of pages7
JournalJournal of the Society of Laparoendoscopic Surgeons
Volume16
Issue number1
DOIs
StatePublished - Jan 2012

Keywords

  • Kidney neoplasm
  • Kidney surgery
  • Minimally invasive surgery

ASJC Scopus subject areas

  • Surgery

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