OBJECTIVE Nationwide register data provide unique opportunities for real-world assessment of complications from different surgical methods. This study aimed to assess incidence of, and predictors for, post-operative complications and to evaluate 90-day mortality following different surgical procedures and thermal ablation for renal cell carcinoma (RCC). MATERIAL AND METHODS All patients undergoing surgical treatment and thermal ablation for RCC in Sweden during 2015-2019 were identified from the National Swedish Kidney Cancer Register. Frequencies and types of post-operative complications were analysed. Logistic regression models were used to identify predictors for 90-day major (Clavien-Dindo grades III-V) complications, including death. RESULTS The overall complication rate was 24% (1295/5505), of which 495 (8.7%) were major complications. Most complications occurred following open surgery, of which bleeding and infection were the most common. Twice as many complications were observed in patients undergoing open surgery compared to minimally invasive surgery (20% vs. 10%, P < 0.001). Statistically significant predictors for major complications irrespective of surgical category and technique were American society of anesthiologists (ASA) score, tumour diameter and serum creatinine. Separating radical and partial nephrectomy, surgical technique remained a significant risk factor for major complications. Most complications occurred within the first 20 days. The overall 90-day readmission rate was 6.2%, and 30- and 90-day mortality rates were 0.47% and 1.5%, respectively. CONCLUSIONS In conclusion, bleeding and infection were the most common major complications after RCC surgery. Twice as many patients undergoing open surgery suffer a major post-operative complication as compared to patients subjected to minimally invasive surgery. General predictors for major complications were ASA score, tumour size, kidney function and surgical technique.

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肾癌手术并发症的预测因素：一项国家注册研究。

目的 全国登记数据为真实世界评估不同手术方法的并发症提供了独特的机会。本研究旨在评估肾细胞癌 (RCC) 术后并发症的发生率和预测因素，并评估不同手术程序和热消融后的 90 天死亡率。材料和方法 2015-2019 年在瑞典接受肾细胞癌手术治疗和热消融的所有患者均来自瑞典国家肾癌登记处。分析术后并发症的频率和类型。Logistic 回归模型用于确定 90 天主要（Clavien-Dindo 分级 III-V）并发症（包括死亡）的预测因子。结果 总并发症发生率为24%（1295/5505），其中主要并发症495例（8.7%）。大多数并发症发生在开放手术后，其中出血和感染是最常见的。与微创手术相比，接受开放手术的患者出现的并发症数量是微创手术患者的两倍（20% vs. 10%，P < 0.001）。无论手术类别和技术如何，主要并发症的统计学显着预测因素是美国麻醉医师协会 (ASA) 评分、肿瘤直径和血清肌酐。除了根治性肾切除术和部分肾切除术之外，手术技术仍然是主要并发症的重要危险因素。大多数并发症发生在前 20 天内。总体 90 天再入院率为 6.2%，30 天和 90 天死亡率分别为 0.47% 和 1.5%。结论 总之，出血和感染是肾细胞癌术后最常见的主要并发症。与接受微创手术的患者相比，接受开放手术的患者出现主要术后并发症的人数是其两倍。主要并发症的一般预测因素是 ASA 评分、肿瘤大小、肾功能和手术技术。