Predictors of Postoperative Complications in Partial Nephrectomy: A Risk-Stratified Analysis of Urine Leak and Hemorrhage Across Open and Robotic Approaches
Main Article Content
Abstract
Objectives:
To identify predictors of these complications across open and robotic PN using an exploratory multivariable assessment.
Methodology:
A retrospective comparative cohort study was carried out at the Department of Urology, Pakistan Kidney and Liver Institute & Research Center, Lahore, where all adults undergoing open or robotic PN were included in the study from January 2020 to August 2025. Continuous demographic, clinical, and perioperative variables have been analyzed using IBM SPSS v27. Independent predictors of postoperative urine leak and hemorrhage will be evaluated using univariate comparisons and binary logistic regression, taking p < 0.05 as a threshold for significance.
Results:
A total of 117 patients were analyzed, including 15 (12.8%) robotic and 102 (87.2%) open PN cases. Tumor size was significantly larger in the open group (median 4.75 cm vs. 3.8 cm; p = 0.015), while operative time was longer in robotic PN (165 vs. 120 minutes; p = 0.071). Urine leak occurred in 6.8% of patients (6.7% robotic vs. 6.9% open; p = 0.978), and postoperative hemorrhage in 4.3% (0% robotic vs. 4.9% open; p = 0.381). Median hospital stay was comparable (2 vs. 3 days; p = 0.768). Logistic regression identified no independent predictors of either complication, though longer operative time showed a non-significant trend toward increased risk.
Conclusion:
Both open and robotic PN had comparable overall rates of postoperative urine leakage and haemorrhage. Therefore, when done on carefully chosen patients, both open and robotic PN can be considered safe.
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