Perioperative Factors Associated with the Conversion of Robotic-Assisted Partial Nephrectomy to Open Partial and...

Area of Science:

• Urology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Robotic-assisted partial nephrectomy (RAPN) is a minimally invasive approach for kidney tumors.
• Conversion to open partial nephrectomy (OPN) or radical nephrectomy (RN) can occur during RAPN.
• Identifying factors predicting conversion is crucial for surgical planning and patient outcomes.

Purpose of the Study:

• To identify perioperative factors associated with conversion from RAPN to OPN or RN.
• To analyze the reasons for conversion and their impact on patient outcomes.

Main Methods:

• Retrospective review of 775 consecutive RAPNs performed by a single surgeon.
• Evaluation of perioperative factors including Mayo Adhesive Probability (MAP) score, operative time (OT), and length of stay (LOS).
• Logistic regression analysis to determine odds ratios (OR) for conversion factors.

Main Results:

• A 4.1% conversion rate was observed (1.7% to RN, 2.5% to OPN).
• Larger tumor size and higher MAP scores were significantly associated with conversion.
• Conversion was linked to increased LOS, longer OT, and higher rates of postoperative complications.

Conclusions:

• Tumor size and MAP score are key predictors of RAPN conversion.
• Conversions during RAPN are associated with adverse perioperative outcomes, including longer operative times and increased complications.