Back to Search
Start Over
A nomogram predicting intraoperative adverse events during minimally invasive radical nephrectomy and thrombectomy.
- Source :
- Surgical Endoscopy & Other Interventional Techniques; Oct2024, Vol. 38 Issue 10, p5891-5902, 12p
- Publication Year :
- 2024
-
Abstract
- Background: To define the incidence and independent predictive factors of intraoperative adverse events (IOAEs) after minimally invasive radical nephrectomy and thrombectomy (RNAT) and to determine the impact of intraoperative adverse events on oncological outcomes. Patients and methods: A total of 294 patients underwent minimally invasive RNAT from January 2010 to December 2023 in our center were included. IOAEs are defined as any deviation from the normal surgical procedure during the operation course. Multivariate logistic regression analysis was performed to identify the independent predictive factors of IOAEs. The Kaplan–Meier curves was used to compare overall survival and cancer-specific survival between patients with IOAEs or not. Results: Seventy-four IOAEs occurred in 57 of 294 patients (19.4%) and the most frequent IOAEs were conversion to open surgery (42/74, 56.7%), followed by excessive hemorrhage (20/74, 27.0%). In multivariate logistic analysis, side (OR 0.0929; 95%Cl 0.0367–0.2160; p < 0.001), operation approach (OR 0.1762; 95%Cl 0.06828–0.4109; p < 0.001), and Mayo grade (OR 6.321; 95%Cl 3.846–11.13; p < 0.001) were independent predictive predictors of IOAEs during minimally invasive RNAT. IOAEs (OR 2.713; 95%Cl 1.242–5.897; p = 0.012) was an independent risk factor of the occurrence of postoperative complications. Between the patients with IOAEs or not, neither overall survival (OS) nor cancer-specific survival (CSS) showed statistical differences. Patients with postoperative complications show shorter OS and CSS. Conclusion: We found that the independent predictive factors of minimally invasive RNAT were side, operation approach and Mayo grade, and it is a risk factor of the occurrence of postoperative complications. In addition, the occurrence of IOAEs had no effect on long-term oncological outcomes. [ABSTRACT FROM AUTHOR]
- Subjects :
- PREDICTION models
RESEARCH funding
T-test (Statistics)
RECEIVER operating characteristic curves
MULTIPLE regression analysis
FISHER exact test
MINIMALLY invasive procedures
NEPHRECTOMY
EVALUATION of medical care
MULTIVARIATE analysis
DESCRIPTIVE statistics
RETROSPECTIVE studies
MANN Whitney U Test
CHI-squared test
SURGICAL complications
KAPLAN-Meier estimator
ODDS ratio
RENAL cell carcinoma
MEDICAL records
ACQUISITION of data
THROMBECTOMY
ADVERSE health care events
CONFIDENCE intervals
DATA analysis software
OVERALL survival
HEMORRHAGE
Subjects
Details
- Language :
- English
- ISSN :
- 18666817
- Volume :
- 38
- Issue :
- 10
- Database :
- Complementary Index
- Journal :
- Surgical Endoscopy & Other Interventional Techniques
- Publication Type :
- Academic Journal
- Accession number :
- 180131536
- Full Text :
- https://doi.org/10.1007/s00464-024-11041-0