Risk Factors for Complications in Simple Nephrectomy: 17-Year Results from Single Institution

Abstract

Objective: To determine which preoperative patient characteristics are predictive of intraoperative complications (IOC) and postoperative complications (POC) in patients undergoing nephrectomy for non-oncological diseases. Materials and Methods: Demographics, pre-operative characteristics, the surgical technique and perioperative outcomes of 295 adult patients who had underwent simple nephrectomy between 2002 and 2019 in a single reference institution were analyzed retrospectively. Univariate and multivariable statistical analyses were performed to determine the factors affecting POC (Clavien-Dindo score ≥1) and IOC. All statistical analyses were performed using the Statistical Package for the Social Sciences v. 24.0 (SPSS Inc., Chicago, IL, USA) software for Windows. Results: The mean age of the patients was 44.84±15.51 years, with a female-to-male ratio of 154/141. The statistically significant factors associated with IOC in the multivariable analysis were male gender, higher American Society of Anesthesiologists (ASA) score and urgent surgical intervention (p=0.002, p=0.001, p=0.021, respectively). In multivariable analysis, preoperative anemia, emergency surgery and open surgery were found to be statistically significant and associated with POC (p<0.001, p=0.004, and p=0.049, respectively). Conclusion: Improved surgical outcomes can be achieved through treatment adapted to individual preoperative characteristics such as ASA score, pre-operative hemoglobin level and male gender. An elective laparoscopic approach should be used whenever possible.