Assessing the perioperative outcomes of abdominal drain omission after robot-assisted partial nephrectomy
Abstract The study aimed to evaluate the impact of abdominal drain placement (vs. omission) on perioperative outcomes of robot-assisted partial nephrectomy (RAPN), focusing on complications, time to canalization, deambulation, and pain management. A prospectively-maintained institutional database wa...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2024-04-01
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| Series: | Scientific Reports |
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| Online Access: | https://doi.org/10.1038/s41598-024-59404-w |
| _version_ | 1827264716929499136 |
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| author | Francesco Ditonno Riccardo Bertolo Alessandro Veccia Sonia Costantino Francesca Montanaro Francesco Artoni Alberto Baielli Michele Boldini Davide Brusa Vincenzo De Marco Filippo Migliorini Antonio Benito Porcaro Riccardo Rizzetto Maria Angela Cerruto Riccardo Autorino Alessandro Antonelli |
| author_facet | Francesco Ditonno Riccardo Bertolo Alessandro Veccia Sonia Costantino Francesca Montanaro Francesco Artoni Alberto Baielli Michele Boldini Davide Brusa Vincenzo De Marco Filippo Migliorini Antonio Benito Porcaro Riccardo Rizzetto Maria Angela Cerruto Riccardo Autorino Alessandro Antonelli |
| author_sort | Francesco Ditonno |
| collection | DOAJ |
| description | Abstract The study aimed to evaluate the impact of abdominal drain placement (vs. omission) on perioperative outcomes of robot-assisted partial nephrectomy (RAPN), focusing on complications, time to canalization, deambulation, and pain management. A prospectively-maintained institutional database was queried to get data of patients who underwent RAPN for renal masses between January 2018 and May 2023 at our Institution. Baseline, surgical, and postoperative data were collected. Retrieved patients were stratified based upon placement of abdominal drain (Y/N). Descriptive analyses comparing the two groups were conducted as appropriate. After adjusting for potential confounders, a logistic regression analysis was conducted to evaluate significant predictors of any grade and “major” complications. 342 patients were included: 192 patients in the “drain group” versus 150 patients in the “no-drain” group. Renal masses were larger (p < 0.001) and at higher complexity (RENAL score, p = 0.01), in the drain group. Procedures in the drain group had statistically significantly longer operative time, ischemia time, and higher blood loss (all p-values < 0.001). The urinary collecting system was more likely involved compared to the no-drain group (p = 0.01). At multivariate analysis, abdominal drainage was not a significant predictor of any grade (OR 0.79, 95%CI 0.33–1.87) and major postoperative complications (OR 3.62, 95%CI 0.53–9.68). Patients in the drain group experienced a statistically significantly higher hemoglobin drop (p < 0.01). Moreover, they exhibited statistically significant higher paracetamol consumption (p < 0.001) and need for additional opioids (p = 0.02). In summary, the study results suggest the safety of omitting drain placement and remark on the need for personalized decision-making, which considers patient and procedural factors. |
| first_indexed | 2024-04-24T07:16:50Z |
| format | Article |
| id | doaj.art-e42d8901697d4eba9630d8f5fc7bebb3 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2025-03-22T03:50:29Z |
| publishDate | 2024-04-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-e42d8901697d4eba9630d8f5fc7bebb32024-04-28T11:20:20ZengNature PortfolioScientific Reports2045-23222024-04-011411810.1038/s41598-024-59404-wAssessing the perioperative outcomes of abdominal drain omission after robot-assisted partial nephrectomyFrancesco Ditonno0Riccardo Bertolo1Alessandro Veccia2Sonia Costantino3Francesca Montanaro4Francesco Artoni5Alberto Baielli6Michele Boldini7Davide Brusa8Vincenzo De Marco9Filippo Migliorini10Antonio Benito Porcaro11Riccardo Rizzetto12Maria Angela Cerruto13Riccardo Autorino14Alessandro Antonelli15Department of Urology, Borgo Trento Hospital, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, AUOI VeronaDepartment of Urology, Borgo Trento Hospital, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, AUOI VeronaDepartment of Urology, Borgo Trento Hospital, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, AUOI VeronaDepartment of Urology, Borgo Trento Hospital, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, AUOI VeronaDepartment of Urology, Borgo Trento Hospital, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, AUOI VeronaDepartment of Urology, Borgo Trento Hospital, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, AUOI VeronaDepartment of Urology, Borgo Trento Hospital, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, AUOI VeronaDepartment of Urology, Borgo Trento Hospital, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, AUOI VeronaDepartment of Urology, Borgo Trento Hospital, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, AUOI VeronaDepartment of Urology, Borgo Trento Hospital, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, AUOI VeronaDepartment of Urology, Borgo Trento Hospital, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, AUOI VeronaDepartment of Urology, Borgo Trento Hospital, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, AUOI VeronaDepartment of Urology, Borgo Trento Hospital, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, AUOI VeronaDepartment of Urology, Borgo Trento Hospital, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, AUOI VeronaDepartment of Urology, Rush University Medical CenterDepartment of Urology, Borgo Trento Hospital, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, AUOI VeronaAbstract The study aimed to evaluate the impact of abdominal drain placement (vs. omission) on perioperative outcomes of robot-assisted partial nephrectomy (RAPN), focusing on complications, time to canalization, deambulation, and pain management. A prospectively-maintained institutional database was queried to get data of patients who underwent RAPN for renal masses between January 2018 and May 2023 at our Institution. Baseline, surgical, and postoperative data were collected. Retrieved patients were stratified based upon placement of abdominal drain (Y/N). Descriptive analyses comparing the two groups were conducted as appropriate. After adjusting for potential confounders, a logistic regression analysis was conducted to evaluate significant predictors of any grade and “major” complications. 342 patients were included: 192 patients in the “drain group” versus 150 patients in the “no-drain” group. Renal masses were larger (p < 0.001) and at higher complexity (RENAL score, p = 0.01), in the drain group. Procedures in the drain group had statistically significantly longer operative time, ischemia time, and higher blood loss (all p-values < 0.001). The urinary collecting system was more likely involved compared to the no-drain group (p = 0.01). At multivariate analysis, abdominal drainage was not a significant predictor of any grade (OR 0.79, 95%CI 0.33–1.87) and major postoperative complications (OR 3.62, 95%CI 0.53–9.68). Patients in the drain group experienced a statistically significantly higher hemoglobin drop (p < 0.01). Moreover, they exhibited statistically significant higher paracetamol consumption (p < 0.001) and need for additional opioids (p = 0.02). In summary, the study results suggest the safety of omitting drain placement and remark on the need for personalized decision-making, which considers patient and procedural factors.https://doi.org/10.1038/s41598-024-59404-wRenal neoplasmRoboticNephrectomyDrainComplications |
| spellingShingle | Francesco Ditonno Riccardo Bertolo Alessandro Veccia Sonia Costantino Francesca Montanaro Francesco Artoni Alberto Baielli Michele Boldini Davide Brusa Vincenzo De Marco Filippo Migliorini Antonio Benito Porcaro Riccardo Rizzetto Maria Angela Cerruto Riccardo Autorino Alessandro Antonelli Assessing the perioperative outcomes of abdominal drain omission after robot-assisted partial nephrectomy Scientific Reports Renal neoplasm Robotic Nephrectomy Drain Complications |
| title | Assessing the perioperative outcomes of abdominal drain omission after robot-assisted partial nephrectomy |
| title_full | Assessing the perioperative outcomes of abdominal drain omission after robot-assisted partial nephrectomy |
| title_fullStr | Assessing the perioperative outcomes of abdominal drain omission after robot-assisted partial nephrectomy |
| title_full_unstemmed | Assessing the perioperative outcomes of abdominal drain omission after robot-assisted partial nephrectomy |
| title_short | Assessing the perioperative outcomes of abdominal drain omission after robot-assisted partial nephrectomy |
| title_sort | assessing the perioperative outcomes of abdominal drain omission after robot assisted partial nephrectomy |
| topic | Renal neoplasm Robotic Nephrectomy Drain Complications |
| url | https://doi.org/10.1038/s41598-024-59404-w |
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