Impact of Implementation of Standardized Criteria in the Assessment of Complication Reporting After Robotic Partial Nephrectomy: A Systematic Review

Giovanni E Cacciamani; Luis G Medina; Alessandro Tafuri; Tania Gill; Willy Baccaglini; Vanessa Blasic; Felipe P A Glina; Andre L De Castro Abreu; René Sotelo; Inderbir S Gill; Walter Artibani

doi:10.1016/j.euf.2018.12.004

Impact of Implementation of Standardized Criteria in the Assessment of Complication Reporting After Robotic Partial Nephrectomy: A Systematic Review

Eur Urol Focus. 2020 May 15;6(3):513-517. doi: 10.1016/j.euf.2018.12.004. Epub 2018 Dec 23.

Affiliations

¹ Urology Institute University of Southern California (USC), Los Angeles, CA, United States; Department of Urology, University of Verona, Verona, Italy. Electronic address: giovanni.cacciamani@med.usc.edu.
² Urology Institute University of Southern California (USC), Los Angeles, CA, United States.
³ Urology Institute University of Southern California (USC), Los Angeles, CA, United States; Department of Urology, University of Verona, Verona, Italy.
⁴ Department of Urology, University of Verona, Verona, Italy; ABC Medical School, Santo André, SP, Brazil.
⁵ Urology Institute University of Southern California (USC), Los Angeles, CA, United States; Lusíada University Center, School of Medical Sciences of Santos, Santos, SP, Brazil.
⁶ Department of Urology, University of Verona, Verona, Italy.

PMID: 30587445
DOI: 10.1016/j.euf.2018.12.004

Abstract

The definition of a surgical complication still lacks standardization, hampering evaluation of surgical performance in this regard. Over the years, efforts to address this issue have been carried out to improve reporting of outcomes. In 2012, the European Association of Urology (EAU) proposed a standardized reporting tool for urological complications. The aim of this study was to evaluate the impact of those recommendations on complication reporting for patients undergoing robotic partial nephrectomy (RPN). A comprehensive systematic review of all English language publications on RPN was carried out. We followed the Preferred Reporting Items for Systematic Review and Meta-Analyses statement and Agency for Healthcare Research and Quality guidelines in evaluating articles retrieved from the PubMed, Scopus, and Web of Science databases (January 1, 2000 to October 31, 2016; updated June 2017). The quality of reporting and grading complications was assessed according to the EAU recommendations. Temporal comparison revealed an improvement in outcome reporting in terms of mortality rates and causes of death (p=0.05), definition of complications (p<0.001), procedure-specific complications (p=0.02), severity grade (p<0.001), postoperative complications presented by grade/complication type (p<0.001), and risk factors (p<0.001). Our analysis demonstrates an improvement in complication reporting and grading after the EAU recommendation on RPN. PATIENT SUMMARY: Complications are unexpected events that could negatively impact a patient's outcomes after surgery, but there is no agreement on the definition and reporting of complications. In 2012, the European Association of Urology proposed a standardized reporting tool for urological complications. This study shows an improvement in the way physicians report complications after robotic partial nephrectomy. The results underline the importance of standardization in medicine to improve clinical research.

Keywords: Complication; European Association of Urology guidelines; Outcome reporting; Robotic partial nephrectomy.

Publication types

Systematic Review

MeSH terms

Guidelines as Topic
Humans
Nephrectomy / methods*
Postoperative Complications*
Research Report / standards*
Robotic Surgical Procedures*