Impact of Polypharmacy on Perioperative Outcomes of Robot-assisted Laparoscopic Partial Nephrectomy for Small Renal Masses.

Background/aim: To clarify the relationship between polypharmacy and perioperative outcomes in patients undergoing robot-assisted laparoscopic partial nephrectomy (RAPN) for small renal masses.

Patients and methods: The clinical data of 2,392 patients who underwent RAPN for clinical T1 renal masses between January 2013 and November 2023 were retrospectively assessed. Polypharmacy was defined as patients taking five or more oral medications at the time of surgery. Perioperative outcomes were compared based on the polypharmacy status by balancing possible biases between the polypharmacy and non-polypharmacy groups using the propensity score matching (PSM) approach.

Results: Of 2,392 patients, 669 (28.0%) were classified into the polypharmacy group. After PSM, 532 non-polypharmacy patients were matched to the polypharmacy group. Patients in the polypharmacy group had a higher risk of perioperative complications (p=0.022) and a longer postoperative hospital stay (p=0.048) than those in the non-polypharmacy group. Additionally, the rate of intraoperative blood transfusions was higher in the polypharmacy group than in the non-polypharmacy group (p=0.088).

Conclusion: Polypharmacy was significantly associated with inverse perioperative outcomes in patients who underwent RAPN for small renal masses. This can aid in determining optimal surgical indications and postoperative monitoring of RAPN.