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. 2024 Jun;31(6):3880-3886.
doi: 10.1245/s10434-024-15106-1. Epub 2024 Mar 8.

Risk Factors of Open Surgery Conversion in Laparoscopic Partial Nephrectomy to Achieve Nephron Sparing

Emin Taha Keskin  1 , Osman Can  2 , Harun Özdemir  2 , Merve Şam Özdemir  3 , Özgür Deniz Tataroğlu  2 , Abdülmuttalip Şimşek  2
Affiliations

Risk Factors of Open Surgery Conversion in Laparoscopic Partial Nephrectomy to Achieve Nephron Sparing

Emin Taha Keskin et al. Ann Surg Oncol. 2024 Jun.

Abstract

Objectives: We aimed to evaluate the risk factors for the conversion from laparoscopic partial nephrectomy (LPN) to open surgery to achieve partial nephrectomy (PN).

Methods: Data from patients who underwent LPN between June 2020 and September 2023 were analyzed retrospectively. Patients in whom the PN procedure could be completed laparoscopically were recorded as the 'Fully Laparoscopic' (FL) group (n = 97), and those converted to open surgery from laparoscopy were recorded as the 'Conversion to Open' (CTO) group (n = 10). The demographic and pathologic variables were compared between groups. Regression analyses were used to define predictor factors, and receiver operating characteristic analysis was used to define the cut-off value of the surgical bleeding volume.

Results: Conversion to open surgery was found in 10/107 patients (9.3%). There was no statistical difference between groups in demographic and pathologic variables. Intraoperative blood loss volume, upper pole localized tumor, and posterior localized tumor were found to be statistically higher in the CTO group (p = 0.001, p = 0.001, and p = 0.043, respectively). Furthermore, these factors were only found to be statistically significant predictors of conversion to open surgery in both univariate and multivariate regression analyses. 235 cc was found to be the cut-off value of intraoperative blood loss volume for predicting conversion to open surgery (p = 0.001).

Conclusion: Using these predictive factors in clinical practice, treatment planning will lead to the possibility of starting the treatment directly with open surgery instead of minimally invasive options, and it may also provide a chance of being prepared for the possibility of conversion to open surgery peroperatively.

Keywords: Conversion to open surgery; Laparoscopy; Partial nephrectomy; Renal cell carcinoma.

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Conflict of interest statement

Emin Taha Keskin, Osman Can, Harun Özdemir, Merve Şam Özdemir, Özgür Deniz Tataroğlu, and Abdülmuttalip Şimşek declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Study selection process
Fig. 2
Fig. 2
Receiver operating characteristic curve of intraoperative blood loss volume (mL) for predicting conversion to open surgery (AUC: 838)
See this image and copyright information in PMC

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