Abstract: PD73-07
Sources of Funding: Stephen Weissman Kidney Cancer Research Fund

Introduction

Partial nephrectomy (PN) is the standard for management for cT1a renal mass and is increasingly used for larger tumors. Compared to radical nephrectomy, however, it may carry a higher risk of procedure-specific complications, including perioperative infections. We determined to identify risk factors for infectious complications after PN

Methods

Single-center retrospective analysis of patients who underwent PN from 7/2008-1/2015. Demographics, disease and operative characteristics (including surgical approach and length of antibiotic coverage), and occurrence and site of infectious complications were reviewed. Rate of infectious complications following PN at the 30 day and 90 day postoperative mark was calculated. Multivariable analyses (MVA) for risk factors associated with infectious complications during the first 30 and 90 days postoperatively were performed

Results

481 patients were analyzed (mean age 63.1 years, 61.3% male/38.7% Female). Median tumor size was 3.5 cm (IQR 1.9-4.7). Minimally invasive PN was performed in 63.1% (N=299) and open PN was performed in 36.9% (N=175). Urine leak occurred in 21 (4.4%). Infection in first 30 days postoperatively occurred in 29 patients (6%), while infection in first 90 days postoperatively occurred in 42 patients (8.7%). Infection sites during the first 30 day period were wound (N=9), urinary tract (N=8), respiratory (N=7), abscess/sepsis (N=4), and C. difficile (N=3). De novo infectious events >30 and < 90 days were wound (N=6), urinary tract (N=4), and abscess/sepsis (N=4). MVA for infectious complications in first 30 days revealed duration of antibiotic therapy >24 hours (OR 1.91, p=0.01) as being the only independent risk factor for development of infectious complication. MVA for infectious complications during first 90 days postoperatively revealed urine leak (OR 6.21, p<0.001) and increasing delta GFR (OR 1.02, p=0.006) as being independent risk factors

Conclusions

Postoperative infectious complications occurred in less than 10% of patients undergoing PN, with most occurring in the first 30 days. Overall wound and urinary tract infections were most common throughout, while abscess/sepsis increased over time, and respiratory and GI/C. difficile decreased over time. Perioperative antibiotics should be limited to <24 hours as part of strategies to reduce risk of infectious sequelae

Funding

Stephen Weissman Kidney Cancer Research Fund