Have we overcome the complications of laparoscopic nephrectomy? A prospective, cohort study using the modified Clavien–Dindo scale
Introduction: Apart from the complexity of procedure and surgeon's experience, surgical complication rates depend on case definition and method of recording data. We prospectively evaluated the complications of laparoscopic nephrectomy (LN) in a current cohort of patients, graded on the modifie...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2017-01-01
|
| Series: | Indian Journal of Urology |
| Online Access: | http://www.indianjurol.com/article.asp?issn=0970-1591;year=2017;volume=33;issue=3;spage=216;epage=220;aulast=Agrawal |
| _version_ | 1819152945608916992 |
|---|---|
| author | Tapan Agrawal Rajeev Kumar Prabhjot Singh Ashish Saini Amlesh Seth Premnath Dogra |
| author_facet | Tapan Agrawal Rajeev Kumar Prabhjot Singh Ashish Saini Amlesh Seth Premnath Dogra |
| author_sort | Tapan Agrawal |
| collection | DOAJ |
| description | Introduction: Apart from the complexity of procedure and surgeon's experience, surgical complication rates depend on case definition and method of recording data. We prospectively evaluated the complications of laparoscopic nephrectomy (LN) in a current cohort of patients, graded on the modified Clavien–Dindo (CD) scale and compared them with historical cohorts.
Methods: In the Institutional Review Board approved protocol, all patients undergoing LN over a 30-month were enrolled in the study. Clinical parameters, operative data, inhospital course, and 30-day follow-up were recorded prospectively in an electronic database by a resident who did not perform any of the surgeries. The complications were analyzed using the CD scale.
Results: A total of 103 patients (age 14–80 years) underwent LN (30 radical, 73 simple) during the study period. Forty-three of these procedures were for inflammatory conditions (stone disease or tuberculosis). Six procedures were converted to open surgery due to vascular injury (2), bowel injury (1), and adhesions (3). There were 45 (46%) complications in the 97 procedures completed laparoscopically including 34 low-grade (CD grade 1, 2) and 11 high-grade (CD grade 3, 4) complications. There was no mortality. Complications were similar in patients undergoing surgery for inflammatory or noninflammatory conditions.
Conclusions: LN continues to be associated with postoperative complications in 46% of cases. However, the complication rates appear to be higher than historical series, possibly due to the more rigorous case-definition and prospective recording. |
| first_indexed | 2024-12-22T14:57:21Z |
| format | Article |
| id | doaj.art-56b963684b0541f9a97ec9357560d032 |
| institution | Directory Open Access Journal |
| issn | 0970-1591 1998-3824 |
| language | English |
| last_indexed | 2024-12-22T14:57:21Z |
| publishDate | 2017-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Urology |
| spelling | doaj.art-56b963684b0541f9a97ec9357560d0322022-12-21T18:22:11ZengWolters Kluwer Medknow PublicationsIndian Journal of Urology0970-15911998-38242017-01-0133321622010.4103/iju.IJU_47_17Have we overcome the complications of laparoscopic nephrectomy? A prospective, cohort study using the modified Clavien–Dindo scaleTapan AgrawalRajeev KumarPrabhjot SinghAshish SainiAmlesh SethPremnath DograIntroduction: Apart from the complexity of procedure and surgeon's experience, surgical complication rates depend on case definition and method of recording data. We prospectively evaluated the complications of laparoscopic nephrectomy (LN) in a current cohort of patients, graded on the modified Clavien–Dindo (CD) scale and compared them with historical cohorts. Methods: In the Institutional Review Board approved protocol, all patients undergoing LN over a 30-month were enrolled in the study. Clinical parameters, operative data, inhospital course, and 30-day follow-up were recorded prospectively in an electronic database by a resident who did not perform any of the surgeries. The complications were analyzed using the CD scale. Results: A total of 103 patients (age 14–80 years) underwent LN (30 radical, 73 simple) during the study period. Forty-three of these procedures were for inflammatory conditions (stone disease or tuberculosis). Six procedures were converted to open surgery due to vascular injury (2), bowel injury (1), and adhesions (3). There were 45 (46%) complications in the 97 procedures completed laparoscopically including 34 low-grade (CD grade 1, 2) and 11 high-grade (CD grade 3, 4) complications. There was no mortality. Complications were similar in patients undergoing surgery for inflammatory or noninflammatory conditions. Conclusions: LN continues to be associated with postoperative complications in 46% of cases. However, the complication rates appear to be higher than historical series, possibly due to the more rigorous case-definition and prospective recording.http://www.indianjurol.com/article.asp?issn=0970-1591;year=2017;volume=33;issue=3;spage=216;epage=220;aulast=Agrawal |
| spellingShingle | Tapan Agrawal Rajeev Kumar Prabhjot Singh Ashish Saini Amlesh Seth Premnath Dogra Have we overcome the complications of laparoscopic nephrectomy? A prospective, cohort study using the modified Clavien–Dindo scale Indian Journal of Urology |
| title | Have we overcome the complications of laparoscopic nephrectomy? A prospective, cohort study using the modified Clavien–Dindo scale |
| title_full | Have we overcome the complications of laparoscopic nephrectomy? A prospective, cohort study using the modified Clavien–Dindo scale |
| title_fullStr | Have we overcome the complications of laparoscopic nephrectomy? A prospective, cohort study using the modified Clavien–Dindo scale |
| title_full_unstemmed | Have we overcome the complications of laparoscopic nephrectomy? A prospective, cohort study using the modified Clavien–Dindo scale |
| title_short | Have we overcome the complications of laparoscopic nephrectomy? A prospective, cohort study using the modified Clavien–Dindo scale |
| title_sort | have we overcome the complications of laparoscopic nephrectomy a prospective cohort study using the modified clavien dindo scale |
| url | http://www.indianjurol.com/article.asp?issn=0970-1591;year=2017;volume=33;issue=3;spage=216;epage=220;aulast=Agrawal |
| work_keys_str_mv | AT tapanagrawal haveweovercomethecomplicationsoflaparoscopicnephrectomyaprospectivecohortstudyusingthemodifiedclaviendindoscale AT rajeevkumar haveweovercomethecomplicationsoflaparoscopicnephrectomyaprospectivecohortstudyusingthemodifiedclaviendindoscale AT prabhjotsingh haveweovercomethecomplicationsoflaparoscopicnephrectomyaprospectivecohortstudyusingthemodifiedclaviendindoscale AT ashishsaini haveweovercomethecomplicationsoflaparoscopicnephrectomyaprospectivecohortstudyusingthemodifiedclaviendindoscale AT amleshseth haveweovercomethecomplicationsoflaparoscopicnephrectomyaprospectivecohortstudyusingthemodifiedclaviendindoscale AT premnathdogra haveweovercomethecomplicationsoflaparoscopicnephrectomyaprospectivecohortstudyusingthemodifiedclaviendindoscale |