EAU 2011 - Complications of the laparoscopic vs. the open techniques in patients with non-metastatic renal cell carcinoma (RCC) treated with partial or radical nephrectomy: A population-based analysis of the United States - Session Highlights

VIENNA, AUSTRIA (UroToday.com) - Unfortunately most series on open nephrectomy and partial nephrectomy as well as laparoscopic nephrectomy and partial nephrectomy are non-randomized and retrospective.

Between 1998 and 2007, a total of 39,770 patients with radical nephrectomy and 8,551 patients with partial nephrectomy were identified from Nationwide Inpatient Sample. Radical nephrectomy was performed in an open (91%) or laparoscopic (9%) manner. For partial nephrectomy, the rates were 94% and 6%, respectively. Age and Charlson comorbidity index were statistically different for radical nephrectomy groups but not partial nephrectomy groups. The complication rate in the radical nephrectomy group was 16% (17% versus 12% in favor of laparoscopy) with hemorrhage/hematoma (31%), digestive (31%), respiratory (23%) and cardiac (9%) being the most frequent complications. Open radical nephrectomy was statistically significantly more frequently associated with respiratory and hemorrhage/hematoma complications than laparoscopic radical nephrectomy. The complication rate in the partial nephrectomy group was 15% (15% versus 11% also in favor of laparoscopy) with digestive (31%), hemorrhage/hematoma (28%), respiratory (26%) and cardiac (9%) being the most frequent complications. The authors concluded that complication rates were comparable between radical and partial nephrectomy as well as between the open and the laparoscopic approach.

From a technical point of view laparoscopic nephrectomy is easier that laparoscopic partial nephrectomy. For both procedures a patient selection bias cannot be excluded. Therefore, the presented results are still important, but not surprising.

 

Presented by Maxine Sun, BSc, et al. at the 26th Annual European Association of Urology (EAU) Congress - March 18 - 21, 2011 - Austria Centre Vienna, Vienna, Austria


Reported for UroToday by Christian Doehn, MD, PhD, Department of Urology, University of Lübeck Medical School, Lübeck Germany.


 

The opinions expressed in this article are those of the UroToday.com Contributing Medical Editor and do not necessarily reflect the viewpoints of the European Association of Urology (EAU)




 



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