1521 LAPAROSCOPIC AND OPEN PARTIAL NEPHRECTOMY: COMPARISON OF COMPLICATIONS USING CLAVIEN GRADING SYSTEM

INTRODUCTION AND OBJECTIVES: To compare postoperative complications in patients who are undergoing laparoscopic partial (LPN) and open partial nephrectomy (OPN) using a standardized complication reporting system. We have also used a scoring system that quantifies the anatomy of renal masses. METHODS: We conducted a retrospective analysis of 189 consecutive patients who had nephrometry scores and underwent elective partial nephrectomy for renal masses by laparoscopic or open technique between January 2000 and December 2009. Demographic, perioperative and complication data were recorded retrospectively. Thirty and 90-day complication rates were compiled and graded using the modified-Clavien complication scale. RESULTS: 107 patients underwent LPN and 82 patients underwent OPN (N 189). OPN patients had higher nephrometry scores compared to the LPN group (7.1 2.4 vs. 5.6 1.8, p 0.001). Surgical and hospitalization times were shorter and EBL was lower in the LPN group (p 0.001). At 30 days, there were more overall complications in the OPN group, whereas there were more major complications (grade 3–5) in the LPN group. However, this did not reach statistical significance. There was no difference in complication rate at 90 days. When subjected to multivariable logistic regression analysis after adjusting for several confounding factors such as age, gender, ASA score, type of partial nephrectomy, nephrometry score, only higher BMI and higher EBL were predictors of more overall complications. CONCLUSIONS: LPN has the advantages of decreased operative time, as well as lower blood loss and a shorter hospital stay. The complication rate in the LPN group is similar to the OPN patients, despite favorable tumor characteristics in LPN patients. Nephrometry score does not predict complications in this limited cohort. Baseline characteristics of patients undergoing laparoscopic and open partial nephrectomy Laparoscopic Open p-value No. patients 107 82