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Postoperative drainage does not prevent complications after robotic partial nephrectomy

World Journal of Urology volume 34, pages 933–938 (2016)Cite this article

Abstract

Objectives

We aimed to assess the impact of a postoperative drainage after RPN.

Methods

A retrospective multicentric study included RPN performed at eight centers between 2010 and 2014. Three centers stopped using postoperative drainage early in their RPN experience, whereas other institutions systematically left a drain. Preoperative characteristics, complication rates, need for postoperative imaging or procedure (surgical or radiological) and length of hospital stay were compared between the two groups [drainage (D) and no drainage (ND)].

Results

Among 636 RPNs, 140 were done without drainage (22 %). In the ND group, surgeons were more experienced (>50 cases: 55.7 vs. 15.1 %; p < 0.0001), and tumors were more complex (RENAL score: 7.6 vs. 6.5; p < 0.0001). Complication rates were similar in both groups (21.9 vs. 20.2 %; p = 0.67). The omission of postoperative drainage did not increase requirement of CT scan (RR = 1.03; 95 % CI 0.64–1.67). Length of hospital stay was shorter in the ND group (4.5 vs. 5.5 days; p = 0.007). There were six urinary fistulas: four in the D group (0.8 %) and two in the ND group (1.4 %; p = 0.49). A CT scan was done to confirm the diagnosis of fistula in every case. In multivariate analysis, the omission of drainage was not associated with increased need of postoperative CT scan or major complications but was a predictor of decreased length of stay.

Conclusion

The omission of postoperative drainage does not seem to increase the risk of postoperative complications and could safely be omitted after RPN.

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Author contributions

Peyronnet, De La Taille, Roupret, Bensalah and Mejean developed the project and protocol. Pradère, Vaessen, Baumert, Bernhard, Doumerc, Droupy and Bruyere contributed to data collection or management. Peyronnet and Bensalah analyzed the data. Peyronnet and Bensalah contributed to manuscript writing/editing.

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Authors and Affiliations

  1. Department of Urology, University of Rennes, 2 rue Henri Le Guilloux, 35000, Rennes, France

    Benoit Peyronnet, Benjamin Pradère & Karim Bensalah

  2. Department of Urology, University of Tours, Tours, France

    Benjamin Pradère & Franck Bruyère

  3. Department of Urology, Henri-Mondor Hospital, Créteil, France

    Alexandre De La Taille

  4. Department of Urology, University of Toulouse, Toulouse, France

    Nicolas Doumerc

  5. Department of Urology, University of Nimes, Nimes, France

    Stéphane Droupy

  6. Department of Urology, La Pitié-Salpétrière Hospital, Paris, France

    Christophe Vaessen & Morgan Rouprêt

  7. Department of Urology, Saint-Joseph Hospital, Paris, France

    Hervé Baumert

  8. Department of Urology, University of Bordeaux, Bordeaux, France

    Jean-Christophe Bernhard

  9. French Research Network on Kidney Cancer (uroCCR), Bordeaux, France

    Jean-Christophe Bernhard

  10. Department of Urology, Georges Pompidou Hospital, Paris, France

    Arnaud Mejean

Authors
  1. Benoit Peyronnet
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  2. Benjamin Pradère
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  3. Alexandre De La Taille
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  4. Franck Bruyère
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  5. Nicolas Doumerc
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  6. Stéphane Droupy
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  7. Christophe Vaessen
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  8. Hervé Baumert
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  9. Jean-Christophe Bernhard
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  10. Morgan Rouprêt
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  11. Arnaud Mejean
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  12. Karim Bensalah
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Corresponding author

Correspondence to Benoit Peyronnet.

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The authors declare that they have no conflict of interest.

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Peyronnet, B., Pradère, B., De La Taille, A. et al. Postoperative drainage does not prevent complications after robotic partial nephrectomy. World J Urol 34, 933–938 (2016). https://doi.org/10.1007/s00345-015-1721-2

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  • DOI: https://doi.org/10.1007/s00345-015-1721-2

Keywords

  • Complications
  • Drain
  • Partial nephrectomy
  • Robotic
  • Urinary fistula