Advanced search
Start date
(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Predictors of surgical complications of nephrectomy for urolithiasis

Full text
Danilovic, Alexandre [1] ; Cunha Ferreira, Thiago Augusto [1] ; de Azevedo Maia, Gilvan Vinicius [1] ; Miranda Torricelli, Fabio Cesar [1] ; Mazzucchi, Eduardo [1] ; Nahas, William Carlos [1] ; Srougi, Miguel [1]
Total Authors: 7
[1] Univ Sao Paulo, Fac Med, Hosp Clin, Div Urol, Rua Petrarca, 35-91 Jardim Vila Mariana, BR-04115010 Sao Paulo, SP - Brazil
Total Affiliations: 1
Document type: Journal article
Source: INTERNATIONAL BRAZ J UROL; v. 45, n. 1, p. 100-107, JAN-FEB 2019.
Web of Science Citations: 1

ABSTRACT Objectives: Nephrectomy due to stone disease may be a challenging procedure owing to the presence of significant inflammation and infection, involving high complication rate. The objective of our study was to identify predictors for complications of nephrectomy for urolithiasis. Patients and Methods: A retrospective review of 149 consecutive patients > 18y submitted to simple nephrectomy for urolithiasis from January 2006 to July 2012 was performed. Clinical data, computed tomography findings and pathology report were analyzed. Postoperative complications were categorized based on Clavien - Dindo classification. Logistic multivariate regression models assessed the predictors for surgical complications of nephrectomy for urolithiasis. Results: Eighty-three (55.7%) patients were submitted to laparoscopic nephrectomy and 66 (44.2%) to open procedure. Conversion to open surgery was necessary in 19.2% (16 / 83). On univariable analysis, higher preoperative chronic kidney stage (p = 0.02), Charlson comorbidity index ≥ 2 (p = 0.04), higher ASA score (p = 0.001), urgency due to sepsis (p = 0.01), kidney size ≥ 12 cm (p = 0.006), renal and perirenal abscess (p = 0.004 and 0.002 respectively) and visceral adhesion (p = 0.04) were associated with Clavien - Dindo score > 1. On multivariate analysis, higher ASA score (p = 0.01), urgency due to sepsis (p = 0.03), kidney size ≥ 12 cm (p = 0.04) and preoperative abscess (p = 0.04) remained significantly associated with complications. End - stage renal disease with dialysis was needed post - operatively in 3.4% (5 / 144) of patients. Conclusions: We identified that higher ASA score, urgency due to sepsis, kidney size ≥ 12 cm and preoperative abscess were associated with Clavien - Dindo score > 1. (AU)

FAPESP's process: 13/18223-6 - Predictors of total nephrectomy complications in patients with kidney stone disease
Grantee:Gilvan Vinícius de Azevedo Maia
Support Opportunities: Scholarships in Brazil - Scientific Initiation