Predictive Factors of Perioperative Significant Complications Following Partial Nephrectomy for Renal Cell Cancer

Abstract

Objective: Estimating surgical complications is crucial to assess the benefit-harm balance of partial nephrectomy (PN), a complex surgical option compared to radical nephrectomy. This study aimed to assess the factors affecting the occurrence of modified Clavien-Dindo grade 2 or higher complications after PN. Materials and Methods: Data of patients who underwent PN due to renal cancer from January 2015 to June 2018 were prospectively collected. Database was analysed retrospectively by dividing into two groups with Clavien-Dindo grade 0-1 complications (group 1) and with grade 2 or higher complications (group 2). The resection technique was classified by the surgeon as enucleation, enucleo-resection or resection according to the Surface-Intermediate-Base (SIB) margin scores of 0, 1 and 2, respectively. Factors affecting the occurrence of grade 2 or higher complications were evaluated by univariate and multivariate regression analysis. Results: A total of 161 patients were included in the study. The overall rate of perioperative complications was 18.6%. Twenty-four patients (14.9%) had grade 2 or higher complications and 11 patients (6.8%) had serious complications (grade 3 or higher). SIB-score was 0 in 103 (63.9%) patients, 1 in 36 (22.4%) patients and 2 in 22 (13.7%) patients. Multivariate binary logistic regression analysis revealed that the C-index [odds ratio (OR): 0.224, 95% confidence interval (CI): 0.092-0.493, p=0.001], laparoscopic surgical technique (OR: 12.668, 95% CI: 2.825-59.326, p=0.001), and SIB-score 1-2 (OR: 2.852, 95% CI: 1.416-9.826, p=0.002) are independent factors in predicting complications of Clavien-Dindo grade 2 or higher. Conclusion: C-index, laparoscopic approach and resection techniques (SIB-score 1-2) are independent factors in predicting perioperative complications of Clavien-Dindo grade 2 or higher following PN.