Les complications de la néphrectomie totale et de la néphrectomie partielle : quelles sont-elles, comment les prévenir et les prendre en charge ? - Université de Rennes Accéder directement au contenu
Article Dans Une Revue Progrès en Urologie Année : 2022

Complications of radical nephrectomy and partial nephrectomy: What are they? How can they be anticipated and managed?

Les complications de la néphrectomie totale et de la néphrectomie partielle : quelles sont-elles, comment les prévenir et les prendre en charge ?

Résumé

INTRODUCTION: Surgical techniques of radical and partial nephrectomy have changed over the last 20years. Indications for partial nephrectomy have widened and mini-invasive surgery (laparoscopy and robotic assistance) has become widely used. However, both still have a significant morbidity. The objective of this article is to review complications of renal surgery and their predictive factors and to offer algorithms of management. METHODS: Recent literature regarding complications of radical and partial nephrectomy was queried using Pubmed engine search. The most relevant articles were analyzed and served as a basis for this work. RESULTS: The literature on complications of radical and partial nephrectomy has a low level of evidence. There are only retrospective series. The most frequent complications of radical nephrectomy occur during surgery in 5-10% of the cases: wound of the pedicle or of an adjacent organ. The management can often be conservative. Laparoscopy has a similar morbidity compare to the open approach but has greatly increased postoperative outcomes and comfort. Partial nephrectomy has a 20% complication rate. Many factors have an impact on the risk of complications (tumor size, inflammation of perirenal fat, access, surgeon experience, centre volume, comorbidities and age of the patient) and must be taken into consideration before advising partial nephrectomy. The two most feared complications of partial nephrectomy are bleeding (per- or postoperative, 10% of the cases) and urinary fistula (<5% of the cases). Robotic assistance is associated with a lower morbidity in many publications. CONCLUSION: Complications after partial and radical nephrectomy are quite frequent but have decreased with the improvement of surgical techniques. French urologists should maintain their interest in novel technologies and simplification of perioperative pathway to further improve patients' outcomes. Copyright
Fichier principal
Vignette du fichier
1-s2.0-S116670872200416X-main.pdf (1.2 Mo) Télécharger le fichier
Origine : Accord explicite pour ce dépôt

Dates et versions

hal-03888947 , version 1 (14-12-2022)

Identifiants

Citer

Karim Bensalah, Géraldine Pignot, Didier Legeais, François Xavier Madec, Cédric Lebacle, et al.. Les complications de la néphrectomie totale et de la néphrectomie partielle : quelles sont-elles, comment les prévenir et les prendre en charge ?. Progrès en Urologie, 2022, 32 (14), pp.928-939. ⟨10.1016/j.purol.2022.09.011⟩. ⟨hal-03888947⟩
27 Consultations
1082 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More