Which factors increase the risk for complications following a partial nephrectomy nephron-sparing surgery (NSS)?

Updated: Apr 01, 2019
  • Author: Reza Ghavamian, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

Most complications of nephron-sparing surgery (NSS) can be managed conservatively. However, the risk of a significant complication increases with the technical complexity of the case. Direct correlation exists between morbidity and the extent of NSS. The least morbidity occurs in enucleation and in situ conservative surgery, in which most tumors are smaller and peripherally located. In these patients, the morbidities of NSS parallel those of radical nephrectomy.

Accordingly, complication rates are higher in larger tumor resections in patients who have multifocal or bilateral tumors or in resections in patients with large tumors in a solitary kidney. Extracorporeal surgery is associated with increased risk of major complications, including renal vascular thrombosis and renal failure. These resections usually involve extensive manipulation of the renal vasculature and collecting system.


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