Evaluation of predictive factors for i-CLARAS (intraoperative complications in laparoscopic renal and adrenal surgery)

The laparoscopic approach represents the standard of treatment for renal and adrenal diseases, and its use is increasing even outside referral centres. Although most procedures are routinely performed, intraoperative complications do not occur, and the rate and predictive factors of these complicati...

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Autores: Territo, Angelo|||0000-0002-5162-5356, di Buono, Giuseppe|||0000-0001-9928-6448, Buscemi, Salvatore|||0000-0002-6295-8113, Mantica, Guglielmo|||0000-0003-4361-4523, Falco, Vincenzo, Palacios, Vital Hevia, Verri, Paolo|||0000-0002-3662-6828, Antelo, Rodrigo, Rosas-Nava, Jesús Emmanuel, Crisan, Nicolae, Andras, Iulia Mădălina, Medas, Fabio|||0000-0002-9546-0178, Amato, Giuseppe|||0000-0002-1352-9291, Romano, Giorgio|||0000-0003-2237-9587, Breda, Alberto|||0000-0002-7842-9048, Agrusa, Antonino|||0000-0003-1276-1475, Agresta, Ferdinando|||0000-0002-6114-1881, Adelfio, Nicoletta, Amparore, Daniele|||0000-0001-5425-5453, Anania, Gabriele, Badalamenti, Giuseppe, Bagolini, Francesco|||0000-0003-4808-6096, Barletta, Gabriele|||0000-0002-5554-684X, Bracale, Umberto Marcello|||0000-0001-9507-9791, Buzoianu, Maximilian, Calò, Pietro Giorgio|||0000-0001-9637-1145, Canu, Gian Luigi|||0000-0003-3233-0269, Cicero, Giuseppe|||0000-0002-4717-437X, Citarrella, Roberto|||0000-0002-1574-8631, Coletta, Pietro|||0000-0002-8501-8087, Corcione, Francesco F., Cuccurullo, Diego, Cucinella, Gaspare|||0000-0003-3280-003X, Cupido, Francesco, D'Angelo, Francesco, Feo, Carlo V.|||0000-0003-0699-5689, Domínguez Gutiérrez, Ana, Gallioli, Andrea|||0000-0002-3316-5691, Gaya, Josep Maria|||0000-0002-4202-222X, Geraci, Girolamo|||0000-0002-8239-9830, Gonzales-Mendez, Gerardo Tena, Guerrieri, Mario, Gullo, Giuseppe|||0000-0003-4269-4269, Iacone, Biancamaria, Labra Salgado, Isaac Roberto, Licitra, Edelweiss Giulia, Lopez Curtis, David, López-Plaza, José Antonio, Micheli, Matilde, Montori, Giulia|||0000-0002-7649-2174, Nevo, Nadav, Oppici, Dario, Arellano, Leandro, Ortenzi, Monica|||0000-0002-6508-6488, Palmieri, Miriam, Piccione, Antonio, Porpiglia, Francesco|||0000-0002-0752-4857, Raffaele, Pablo Miguel, Reggio, Stefano, Russo, Gaia, Sánchez Molina, Raúl|||0000-0002-1288-7716, Sanz Gomez, Isabel, Saverino, Marta, Sibillla, Maria Grazia, Silecchia, Gianfranco|||0000-0003-2356-0505, Stigliano, Antonio|||0000-0002-7143-0775, Tedesco, Anna, Telecan, Teodora, Terrone, Carlo|||0000-0002-2492-7279, Valerio, Maria Rosaria, Vecco, Francesco, Vella, Roberta, Vitale, Francesco
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:304079
Acceso en línea:https://ddd.uab.cat/record/304079
https://dx.doi.org/urn:doi:10.1038/s41598-024-51696-2
Access Level:acceso abierto
Palabra clave:Adrenalectomy
Humans
Intraoperative Complications
Laparoscopy
Nephrectomy
Postoperative Complications
Retrospective Studies
Treatment Outcome
Descripción
Sumario:The laparoscopic approach represents the standard of treatment for renal and adrenal diseases, and its use is increasing even outside referral centres. Although most procedures are routinely performed, intraoperative complications do not occur, and the rate and predictive factors of these complications have not been established. The aim of this study was to evaluate the incidence and type of intraoperative complications and to identify predictive factors in patients undergoing laparoscopic renal and adrenal surgery. This was a cohort, multicentre, international retrospective study. Patients who underwent laparoscopic renal and adrenal surgeries between April 2017 and March 2022 were included in the study. Bivariate analysis was performed using contingency tables and the χ test for independent samples to compare qualitative variables and the T test and Mood test for continuous variables. Multivariate analysis was performed using a logistic regression model to obtain adjusted odds ratios. A total of 2374 patients were included in the study. Intraoperative complications were reported for 8.09% of patients who underwent renal surgery, with the most common complications reported being hollow viscus and vascular complications, and for 6.75% of patients who underwent adrenal surgery, with the most common complication reported being parenchymatous viscous complications. Multivariate analysis revealed that both adrenal and renal surgery radiological preoperative factors, such as invasive features during adrenalectomy and the RENAL score during nephrectomy, are predictive factors of intraoperative complications. In contrast to existing data, surgeon experience was not associated with a reduction in the incidence of perioperative complications.

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