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Elsevier, European Urology, 2(61), p. 395-402, 2012

DOI: 10.1016/j.eururo.2011.10.046

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Predictors of Warm Ischemia Time and Perioperative Complications in a Multicenter, International Series of Robot-Assisted Partial Nephrectomy

This paper was not found in any repository, but could be made available legally by the author.
This paper was not found in any repository, but could be made available legally by the author.

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Abstract

BACKGROUND: Warm ischemia time (WIT) and complication rates are two important parameters for evaluating the perioperative results of robot-assisted partial nephrectomy (RAPN). Few data are available about the clinical predictors of WIT and overall complications. OBJECTIVE: To identify clinical predictors of WIT and perioperative complications. DESIGN, SETTING, AND PARTICIPANTS: This is a retrospective study including 347 patients who underwent RAPN for suspicious renal cell carcinoma (RCC) at four referral centers from September 2008 to September 2010. INTERVENTION: All patients underwent RAPN using the da Vinci S Surgical System with hilar clamping. MEASUREMENTS: WIT >20 min and overall complication rates were the main outcomes. Postoperative complications were classified according to the Clavien/Dindo system. Moreover, the following perioperative variables were considered: clinical tumor size, anatomical tumor characteristics according to Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) classification score, surgeon experience, console time, blood loss, and upper collecting system (UCS) repair. RESULTS AND LIMITATIONS: WIT >20 min was reported in 125 (36%) cases. Intraoperative and postoperative complications were observed in 10 (2.9%) and 41 (11.8%) cases, respectively. Surgeon experience (odds ratio [OR]: 6.381; 95% confidence interval [CI], 3.687-11.042; p20 min. Similarly, surgeon experience (OR: 3.937; 95% CI, 2.011-7.705; p