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Related Experiment Videos

Intraoperative conversion of laparoscopic partial nephrectomy.

Soroush Rais-Bahrami1, Guilherme C Lima, Ioannis M Varkarakis

  • 1The James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287-8915, USA.

Journal of Endourology
|March 22, 2006
PubMed
Summary

Older age and larger tumor size increase the risk of converting laparoscopic partial nephrectomy (LPN) to open surgery or laparoscopic radical nephrectomy (LRN). These factors predict conversion when liberal selection criteria are used.

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Area of Science:

  • Urology
  • Surgical Oncology

Background:

  • Laparoscopic partial nephrectomy (LPN) is a standard treatment for kidney tumors.
  • Liberal selection criteria may increase conversion rates to open surgery or radical nephrectomy.

Purpose of the Study:

  • To assess the incidence of conversion from LPN to open surgery or laparoscopic radical nephrectomy (LRN).
  • To identify predictive factors for conversion under liberal selection criteria.

Main Methods:

  • Retrospective review of 257 patients undergoing LPN from 2000-2004.
  • Comparison of preoperative risk factors, intraoperative course, and outcomes between converted and completed LPN cases.

Main Results:

  • Conversion to LRN occurred in 13.6% and to open surgery in 1.6% of cases.

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  • Higher age (>70 years), larger tumor size (>4.0 cm), and hypertension were associated with conversion.
  • Patients over 70 had a 3.8-fold higher risk; tumors >4.0 cm had a 4-fold increased likelihood of conversion.

    • Conclusions:

    • Tumor size and patient age are significant predictors of conversion from LPN.
    • Other factors like sex, tumor stage, comorbidities, and surgeon experience did not predict conversion.