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Renal anatomical classification systems cannot predict the occurrence of vascular complications after partial nephrectomy

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Abstract

Objectives

To determine the relationship between renal tumor complexity and vascular complications after partial nephrectomy using PADUA, RENAL, and ZS scores.

Methods

Between January 2007 and December 2018, a total of 1917 patients with available cross-sectional imaging were enrolled in the study. Logistic regressions were used to identify independent predictors of vascular complications.

Results

Of 1917 patients, 31 (1.6%) developed vascular complications, including 10 females and 21 males. The high-complexity category was significantly associated with a decreased risk of vascular complication in PADUA (OR = 0.256; 95%CI = 0.086–0.762; P = 0.014) and ZS score (OR = 0.279; 95%CI = 0.083–0.946; P = 0.040). Laparoscopic partial nephrectomy and robot-assisted laparoscopic partial nephrectomy were independent risk factors for vascular complications. Meanwhile, the incidence was significantly reduced in the recent 4 years in the high score tumor group alone in PADUA (0.2% [1/474] vs. 2.2% [3/139], P = 0.038) and ZS score (0.2% [1/469] vs. 2.7% [3/112], P = 0.024). In the first 8 years, laparoscopic partial nephrectomy and robot-assisted laparoscopic partial nephrectomy were the only two independent risk factors for vascular complications. In the recent 4 years, only the high-complexity category was significantly associated with a decreased risk of vascular complication in the PADUA score (OR = 0.110; 95%CI = 0.013–0.938; P = 0.044).

Conclusion

The renal anatomic classification system cannot predict the occurrence of vascular complications after partial nephrectomy.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Abbreviations

PN:

Partial nephrectomy

ACS:

Anatomical classification system

PA:

Pseudoaneurysm

AVF:

Arteriovenous fistula

OPN:

Open partial nephrectomy

MIPN:

Minimally invasive partial nephrectomy

LPN:

Laparoscopic partial nephrectomy

RAPN:

Robot-assisted partial nephrectomy

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Funding

This study was funded by the Shanghai Municipal Health Bureau (No. 2019SY073), the Special Fund for Clinical Research of Zhongshan Hospital, Fudan University (No. 2020ZSLC16), the Special Fund for Smart Medical of Zhongshan Hospital, Fudan University (2020ZHZS20), the National Natural Science Foundation of China (Grant No. 62273099), the Natural Science Foundation of Shanghai (Grant No. 22ZR1458000), the Medical Research Project of Xuhui District (SHXH202228), and the Shanghai Science and Technology Commission (Grant No. 22Y11905300).

Author information

Author notes

  1. Peirong Xu and Guanwen Yang co-first author.

Authors and Affiliations

  1. Department of Urology, Zhongshan Hospital, Fudan University, 180th Fengling Rd, Xuhui District, Shanghai, 200032, China

    Peirong Xu, Guanwen Yang, Yanjun Zhu, Sihong Zhang, Yaohui Li, Shuai Jiang, Xiaoyi Hu, Jianming Guo & Hang Wang

  2. Department of Urology, Xuhui Hospital, Fudan University, 966th Huaihai Middle Rd, Xuhui District, Shanghai, 200031, China

    Peirong Xu, Liang Pan, Jie Cheng & Hang Wang

  3. Department of Urology, Minhang Hospital, Fudan University, Shanghai, 201199, China

    Minke He & Jiaqi Huang

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  1. Peirong Xu
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Contributions

HW: Protocol/project development/manuscript editing. JC: Protocol/project development. PX: Data collection/analysis/manuscript writing. GY: Data collection/analysis. YZ: Data collection. SZ: Data collection/analysis. YL: Data collection/analysis. MH: Data collection/analysis. JH: Protocol development. SJ: Protocol development. XH: Data collection. All authors read and approved the final manuscript. All authors agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding authors

Correspondence to Jie Cheng or Hang Wang.

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The authors declare that they have no conflict of interest. All the authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

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None. This is a systematic review and meta-analysis study.

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Xu, P., Yang, G., Pan, L. et al. Renal anatomical classification systems cannot predict the occurrence of vascular complications after partial nephrectomy. World J Urol 42, 208 (2024). https://doi.org/10.1007/s00345-024-04891-9

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