Korean J Urol Oncol.  2017 Dec;15(3):165-171. 10.22465/kjuo.2017.15.3.165.

Factor Analysis of Intraoperative Radical Conversion During Partial Nephrectomy: Single Surgeon Experience

• Lee DH
• Cha WH
• Chung Y
• Kim TJ
• Lee IJ
• Song BD
• Lee S
• Hong SK
• Oh JJ
• Byun SS

• KMID: 2402599
• DOI: http://doi.org/10.22465/kjuo.2017.15.3.165

Abstract

PURPOSE
Preoperative aspects and dimensions used for an anatomical (PADUA) classification is useful to predict perioperative complications and warm ischemia time. However, it remains uncertain whether PADUA classification can predict intraoperative conversion from partial nephrectomy (PN) to radical nephrectomy (RN). We evaluate whether PADUA classification parameters can predict conversion to RN during PN.
MATERIALS AND METHODS
We retrospectively assessed data of 593 patients who underwent open PN and robotic PN for renal tumors by a single surgeon at a single tertiary center between December 2003 and September 2017. Intraoperative conversion to RN was performed in 17 of 593 patients who initially underwent PN. We evaluated the factors influencing the surgical modalities including PN and radical conversion cases. Then, the factors significantly associated with conversion to RN were further analyzed.
RESULTS
There were no significant differences between the 2 groups in age, longitudinal location, exophytic rate, and rim or face locations of renal masses. Renal sinus involvement, urinary collecting system involvement, and renal mass size were variables that predicted radical conversion, using univariate analysis. Renal sinus involvement (odds ratio [OR], 9.075; p=0.049) and urinary collecting system involvement (OR, 3.944; p=0.029) were independent predictors of intraoperative radical conversion, using multivariate analysis.
CONCLUSIONS
The PADUA classification is a useful tool to predict intraoperative conversion from PN to RN. Renal sinus involvement and urinary collecting system involvement are the best predictors of intraoperative conversion from PN to RN.

Keyword

Nephrectomy; Operative surgical procedure; Classification; Prediction

MeSH Terms

Classification
Factor Analysis, Statistical*
Humans
Multivariate Analysis
Nephrectomy*
Retrospective Studies
Surgical Procedures, Operative
Warm Ischemia