We aimed to assess the impact of a postoperative drainage after RPN.
A retrospective multicentric study included RPN performed at eight centers between 2010 and 2014. Three centers stopped using postoperative drainage early in their RPN experience, whereas other institutions systematically left a drain.
Preoperative characteristics, complication rates, need for postoperative imaging or procedure (surgical or radiological) and length of hospital stay were compared between the two groups [drainage (D) and no drainage (ND)].
Among 636 RPNs, 140 were done without drainage (22 %). In the ND group, surgeons were more experienced (>50 cases: 55. 7 vs. 15. 1 %; p < 0. 0001), and tumors were more complex (RENAL score: 7. 6 vs. 6. 5; p < 0. 0001). Complication rates were similar in both groups (21. 9 vs. 20. 2 %; p = 0. 67). The omission of postoperative drainage did not increase requirement of CT scan (RR = 1. 03; 95 % CI 0. 64-1. 67). Length of hospital stay was shorter in the ND group (4. 5 vs. 5. 5 days; p = 0. 007). There were six urinary fistulas: four in the D group (0. 8 %) and two in the ND group (1. 4 %; p = 0. 49). A CT scan was done to confirm the diagnosis of fistula in every case. In multivariate analysis, the omission of drainage was not associated with increased need of postoperative CT scan or major complications but was a predictor of decreased length of stay.
The omission of postoperative drainage does not seem to increase the risk of postoperative complications and could safely be omitted after RPN.
World journal of urology. 2015 Oct 28 [Epub ahead of print]
Benoit Peyronnet, Benjamin Pradère, Alexandre De La Taille, Franck Bruyère, Nicolas Doumerc, Stéphane Droupy, Christophe Vaessen, Hervé Baumert, Jean-Christophe Bernhard, Morgan Rouprêt, Arnaud Mejean, Karim Bensalah
Department of Urology, University of Rennes, 2 rue Henri Le Guilloux, 35000, Rennes, France. Department of Urology, University of Rennes, 2 rue Henri Le Guilloux, 35000, Rennes, France. , Department of Urology, Henri-Mondor Hospital, Créteil, France. , Department of Urology, University of Tours, Tours, France. , Department of Urology, University of Toulouse, Toulouse, France. , Department of Urology, University of Nimes, Nimes, France. , Department of Urology, La Pitié-Salpétrière Hospital, Paris, France. , Department of Urology, Saint-Joseph Hospital, Paris, France. , Department of Urology, University of Bordeaux, Bordeaux, France. , Department of Urology, La Pitié-Salpétrière Hospital, Paris, France. , Department of Urology, Georges Pompidou Hospital, Paris, France. , Department of Urology, University of Rennes, 2 rue Henri Le Guilloux, 35000, Rennes, France.