Joudi FN et al. (2007) Analysis of complications following partial and total nephrectomy for renal cancer in a population based sample. J Urol 177: 1709–1714

Renal malignancy is treated by total nephrectomy (TN) or, if the renal mass is ≤4 cm, partial nephrectomy (PN) to preserve renal function. Population-based findings on the frequency of complications and predictors of morbidity associated with both procedures are lacking; therefore, Joudi et al. set about answering these questions in a large US population-based study.

Retrospective analysis of the US Nationwide Inpatient Sample (NIS) data set of the Healthcare Cost and Utilization project identified patients who had undergone PN (n = 3,019) or TN (n = 18,575) for renal cancer between 2000 and 2003. The risk of complications following PN and TN and their effects on mortality and length of hospital stay were assessed by multivariate analysis. The roles of hospital-related factors (volume, location, teaching status, bed size) and patient-related factors (age, sex, comorbid severity index) were also investigated. PN and TN procedures were associated with similar mortality (0.66% and 1.06%) and complication rates (17.16% and 18.20%). The most frequent complications for both procedures were respiratory, digestive or bleeding-related. Length of hospital stay and associated hospital charges were similar for PN and TN. Significant predictors for complications following TN were age, sex, comorbidity index and hospital location (rural versus urban), whereas comorbidity index >2 was the only significant predictor for complications following PN.

This population-based study reports similarly low mortality and morbidity for TN and PN, in agreement with the findings of single-institution studies.