Preoperative Risk Factor Analysis of Prolonged Retroperitoneoscopic Radical Nephrectomy

Area of Science:

• Urology
• Surgical Oncology
• Medical Imaging

Background:

• Renal cell carcinoma (RCC) treatment often involves radical nephrectomy.
• Retroperitoneoscopic radical nephrectomy (RRN) is a minimally invasive surgical approach.
• Identifying preoperative risk factors for prolonged operative time in RRN is crucial for surgical planning.

Purpose of the Study:

• To investigate preoperative risk factors associated with extended operating times during retroperitoneoscopic radical nephrectomy (RRN) for renal cell carcinoma (RCC).

Main Methods:

• Retrospective review of 79 patients undergoing RRN between January 2015 and December 2021.
• Collection of clinical and radiological data, including visceral fat area (VFA), subcutaneous fat area (SFA), and posterior perirenal fat thickness (PFT).
• Analysis of operating time using univariate and multivariate logistic regression.

Main Results:

• A posterior perirenal fat thickness (PFT) exceeding 25 mm was identified as a significant risk factor in univariate analysis (p=0.006).
• Multivariate analysis confirmed that posterior PFT >25 mm is an independent preoperative risk factor for prolonged RRN operating time (p=0.008, OR: 7.29).
• Other factors like right-sided tumors and tumor size >7 cm were significant in univariate analysis but not independently predictive.

Conclusions:

• Posterior perirenal fat thickness greater than 25 mm independently predicts prolonged operating time in RRN for RCC.
• For patients with posterior PFT >25 mm, surgeons should consider alternative surgical strategies, such as a transperitoneal approach, to mitigate extended operative times.