ADEM SANCI, HÜSEYİN MERT DURAK, REYHAN İŞLEK ÖZENÇ, FURKAN ÇAPAR, METİN YIĞMAN, KUBİLAY SARIKAYA, AZMİ LEVENT SAĞNAK, AHMET NİHAT KARAKOYUNLU
Bulletin of Urooncology - 2025;24(2):52-56
OBJECTIVE This study aims to compare perioperative adverse effects between patients classified as American Society of Anesthesiologists (ASA) 1-2 and ASA 3-4 undergoing major oncological urological surgeries. It also evaluates the impact of ASA classification on surgical outcomes. Materials and Methods A retrospective analysis was conducted on patients who underwent open, laparoscopic, or robotic surgery for bladder, kidney, ureter, and prostate cancer between 2022 and 2024. Patients were categorized into two groups: ASA 1-2 (group 1) and ASA 3-4 (group 2). Perioperative complications were classified using the Clavien-Dindo grading system, focusing on grade 4-5 complications. Statistical analyses were performed using chi-square and Mann-Whitney U tests, with p<0.05 considered statistically significant. RESULTS A total of 367 patients were included in the study: 198 radical prostatectomy cases, 76 nephrectomy cases, 41 partial nephrectomy cases, 30 cystectomy cases, and 22 nephroureterectomy cases. Of these, 198 patients were classified as ASA 1-2, while 169 were ASA 3-4. Grade 4-5 complications included pulmonary embolism, sepsis, myocardial infarction, atrial fibrillation, disseminated intravascular coagulation, and death. However, there was no statistically significant difference in the incidence of major complications between ASA groups across different surgical procedures (p>0.05). CONCLUSION Despite the expectation of higher complication rates in ASA 3-4 patients, no significant difference was observed between ASA-groups in perioperative adverse effects. This finding suggests that optimized perioperative management and advanced surgical techniques may mitigate the impact of ASA classification on surgical outcomes in oncological urology.
