Comparison of complications after radical and partial nephrectomy: Resultsfrom the National Veterans Administration Surgical Quality Improvement Program

Objective To determine whether radical nephrectomy causes less morbidity, l ess mortality and is associated with a shorter hospital stay than is partia l nephrectomy. Patients and methods A total of 1885 nephrectomies (1373 radical and 512 pa rtial) conducted between 1991 and 1998 in the Department of Veterans Affair s (VA) National Surgical Quality Improvement Program were evaluated. Using multivariate analyses, outcomes were risk-adjusted based on 45 preoperative variables to compare mortality and morbidity rates. Results The unadjusted 30-day mortality was 2.0% for radical and 1.6% for p artial nephrectomy (P = 0.58). Risk-adjusting the two groups did not result in a statistically significant difference in mortality. The 30-day overall morbidity rate was 15% for radical and 16.2% for partial nephrectomy (P = 0.52); risk-adjusted morbidity rates were not statistically different. Ther e were no statistically significant differences in the rates of postoperati ve progressive renal failure, acute renal failure, urinary tract infection, prolonged ileus, transfusion requirement, deep wound infection, or extende d length of stay. Conclusions Partial nephrectomy carried out in the VA program has low morbi dity and mortality rates, comparable with the complication rates after radi cal nephrectomy.