Postsurgical complications in patients with renal tumors with venous thrombosis treated with surgery

Abstract

Background and objective

Surgery on renal tumors with venous tumor thrombus presents a high complication rate and non-negligible perioperative mortality. Our objective was to analyze the postoperative complications, their relationship with the level of the tumor thrombus and its potential predisposing factors.

Materials and methods

A retrospective analysis was conducted in 101 patients with renal and venous tumor thrombus operated on between 1988 and 2017. Two patients were excluded because of intraoperative pulmonary thromboembolism and exitus (2%). The postsurgical complications were classified according to Clavien–Dindo classification system.

To compare the qualitative variables, we employed the chi-squared test. We performed a multivariate analysis using binary logistic regression to identify the independent predictors.

Results

Some type of postsurgical complication occurred in 34 (34.3%) patients, 11 (11.1%) of which were severe (Clavien III–V). There were significant differences in the total complications (p = 0.003) and severe complications (Clavien ≥ III; p = 0.03) depending on the level of the tumor thrombus.

Resumen

Introducción y objetivo

La cirugía de los tumores renales con trombosis venosa está gravada con un porcentaje elevado de complicaciones y con una mortalidad perioperatoria no despreciable. Nuestro objetivo es analizar las complicaciones postoperatorias, su relación con el nivel del trombo y sus posibles factores favorecedores.

Materiales y métodos

Análisis retrospectivo de 101 pacientes con tumores renales con trombosis venosa intervenidos entre 1988 y 2017. Se descartaron 2 pacientes por TEP intraoperatorio y exitus (2%). Las complicaciones posquirúrgicas se clasificaron según Clavien-Dindo.

Para el contraste de variables cualitativas se ha utilizado el test de la Chi cuadrado. Se realizó un análisis multivariante mediante regresión logística binaria para identificar las variables predictoras independientes.

Resultados

En 34 (34,3%) pacientes se produjo algún tipo de complicación posquirúrgica, siendo en 11 (11,1%) graves (Clavien III-IV). Existen diferencias significativas en las complicaciones totales (p = 0,003) y las graves (Clavien ≥ III) (p = 0,03) según el nivel del trombo tumoral.