To explore the risk factors associated with postoperative complications and prolonged length of stay (LOS) following retroperitoneal laparoscopic radical nephrectomy (LRN).

A retrospective data gathering from 103 patients in Beijing Anzhen hospital who underwent retroperitoneal LRN from Aug. 2010 to Aug. 2021 was conducted. The demographic and clinical data of the patients, including age, gender, Body Mass Index (BMI), comorbidities, American Society of Anesthesiologists (ASA) score, previous abdominal surgery, tumor size, T stage, intraoperative blood loss, intraoperative blood transfusions, postoperative complications and postoperative length of stay, were retrospectively collected. We examined the overall postoperative complications, which were categorized using the Dindo-Clavien classification system. A prolonged LOS was quantified in terms of postoperative hospital stay >10 days, which was defined as LOS >75th percentile of the dataset. Furthermore, univariate and multivariate logistic analysis were performed to identify the risk factor related to postoperative Clavien-Dindo complications and prolonged LOS.

Overall, 103 participants participated in the study. A total of 16 cases (15.5%) suffered postoperative complications of Clavien-Dindo classification grade of 2 or more, and 17 cases (16.5%) had prolonged LOS. The risk factors associated with an increased prevalence of postoperative complications in a multivariate analysis were: operation time ≥240 minutes (OR: 5.17, P=0.024) and intraoperative blood loss >300 ml (OR: 22.89, P=0.001). Those associated with an increased prevalence of prolonged LOS was intraoperative blood transfusion (OR: 9.94, P=0.023).

Postoperative complications and prolonged LOS following LRN were related to intraoperative blood loss, operative time, and intraoperative blood transfusion.