Presentation Authors: Giovanni E. Cacciamani*, Luis Medina, Tania Gill, Alessandro Tafuri, Willy Baccaglini, Felipe glina, Vanessa Blasic, Matthew Winter, Akbar Ashrafi, Andre De Castro Abreu, Rene Sotelo, Los Angeles, CA, Walter Artibani, Verona, Italy, Inderbir Gill, Los Angeles, CA
Introduction: The definition of a surgical complication still lacks standardization, hampering evaluation of surgical performance in this regard. In 2012, the European Urological Association of Urology (EAU) proposed a standardized reporting tool for urological complications. The aim of this study is to evaluate the impact of these recommendations on the complication reporting in patients undergoing robotic partial nephrectomy (RPN).
Methods: A comprehensive systematic review of all English language publications on RPN was performed. We followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) statement and AHRQ (Agency for Healthcare Research and Quality) guidelines to evaluate PubMedÂ®, ScopusÂ® and Web of Scienceâ„¢ databases (January 1, 2000 to October 31, 2016. updated June 2017). Quality of reporting and grading complications were assessed according to the EAU recommendations.
Results: Our electronic search identified 1,093 RPN publications for detailed review, which yielded 114 case series and 155 comparative studies: 61 (22.6%) published before 2012, while 208 (77.3%) afterwards. In aggregate, 231 (85.8%) of the papers report complications as outcomes of interest. A temporal comparison showed an improvement in outcome reporting in terms of mortality/causes of death rates (11% vs 24%: p=0.05), definitions of complications (33% vs 52%: p < 0.001), severity complication grade (42% vs 92%: p < 0.001), postoperative complications presented in a table (36% vs 69%: p < 0.001) and risk factors included in analysis (23% vs 46%: p < 0.001).
Conclusions: Our results showed that the EAU recommendation on complication reporting may had a positive impact on the outcome measurement after RPN. However, more effort is required in order to improve the complication measurements, to guarantee more accurate and comprehensive information on patients undergoing RPN.