Difficulty prediction and risk factor analysis of laparoscopic simple nephrectomy

Lin Fan, Li Junwu, Luo Shengjun

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Journal of Chongqing Medical University ›› 2024, Vol. 49 ›› Issue (06) : 730-735. DOI: 10.13406/j.cnki.cyxb.003531
Urinary system tumors

Difficulty prediction and risk factor analysis of laparoscopic simple nephrectomy

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Abstract

Objective To investigate the clinical characteristics of patients undergoing laparoscopic nonfunctional nephrectomy and to analyze the factors associated with the complexity of the procedure between patients with and without a history of upper urinary tract surgery. Methods Clinical data of patients who underwent laparoscopic nonfunctional nephrectomy at The First Affiliated Hospital of Chongqing Medical University between January 2017 and November 2023 were collected to retrospectively analyze the general characteristics of patients with and without a history of upper urinary tract surgery as well as changes in perioperative indicators. The complexity of laparoscopic simple nephrectomy was assessed using indicators such as operative time，estimated blood loss，rate of intraoperative conversion to open nephrectomy，postoperative complications，and postoperative hospitalization time. Results A total of 293 patients were included and 94 of these patients had a history of upper urinary tract surgery. Estimated blood loss，rate of intraoperative conversion to open nephrectomy，and operative time were increased in patients with a history of upper urinary tract surgery compared with patients without such surgery（P<0.001），whereas there was no significant difference in postoperative hospitalization time. In the univariate analysis，history of upper urinary tract surgery（P<0.001） was the only factor affecting estimated blood loss. Logistic regression models showed that history of upper urinary tract surgery（OR=3.858，95%CI=1.796-8.287，P=0.001） and body mass index（OR=4.074，95%CI=1.887-8.796，P=0.001） were independent predictors of prolonged operative time. Conclusion The complexity of laparoscopic simple nephrectomy is influenced by several factors. History of upper urinary tract surgery is an independent factor affecting operative time and estimated blood loss. In treatment of patients with a history of upper urinary tract surgery，it is important to rationally select the surgical approach and treatment strategy based on their clinical characteristics.

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laparoscopy / minimally invasive surgery / non-functioning kidney

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Lin Fan , Li Junwu , Luo Shengjun. Difficulty prediction and risk factor analysis of laparoscopic simple nephrectomy. Journal of Chongqing Medical University. 2024, 49(06): 730-735 https://doi.org/10.13406/j.cnki.cyxb.003531

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