Date of Presentation

5-5-2022 12:00 AM

College

School of Osteopathic Medicine

Poster Abstract

Minimally invasive surgery (MIS) has been adopted as an approach in kidney surgery. Laparoscopic kidney surgery has been introduced in the 1990s with robotics emerging a decade after. The minimally invasive approach has been technically feasible and has been shown to be noninferior with preserved oncology standards to open surgery. The ubiquitous use of MIS for kidney cancer has been standard of practice; however, unplanned conversion to open kidney surgery has been characterized at 4.9% for laparoscopic radical nephrectomy compared to 6.0% in robotic radical nephrectomy. Another analysis of 54,246 patients undergoing partial nephrectomy for kidney cancer observed an unplanned open conversion rate of 2.87% for cT1 renal masses. Furthermore, the unplanned conversion to open radical or partial nephrectomy after an attempted minimally invasive approach has been an independent predictor of increased risk of 30-day hospital readmission. Currently, the relative risk factors to predict unplanned conversion to open surgery has not been well characterized. Greater understanding of risk factors for unplanned open conversion has clinical implications to reduce intraoperative and postoperative outcomes. The early recognition of nationwide risk and predictors may aid in identifying patients for planned open kidney surgery. We aim to use the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database to identify predictors and outcomes in a contemporary cohort.

Keywords

Nephrectomy, American College of Surgeons National Surgical Quality Improvement Program, ACS-NSQIP, Laparoscopy, Surgical Procedures, Intraoperative Complications

Disciplines

Medicine and Health Sciences | Nephrology | Surgery | Surgical Procedures, Operative | Urogenital System

Document Type

Poster

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May 5th, 12:00 AM

Factors Associated with Unplanned Conversion to Open in Nephrectomy for Kidney Cancer

Minimally invasive surgery (MIS) has been adopted as an approach in kidney surgery. Laparoscopic kidney surgery has been introduced in the 1990s with robotics emerging a decade after. The minimally invasive approach has been technically feasible and has been shown to be noninferior with preserved oncology standards to open surgery. The ubiquitous use of MIS for kidney cancer has been standard of practice; however, unplanned conversion to open kidney surgery has been characterized at 4.9% for laparoscopic radical nephrectomy compared to 6.0% in robotic radical nephrectomy. Another analysis of 54,246 patients undergoing partial nephrectomy for kidney cancer observed an unplanned open conversion rate of 2.87% for cT1 renal masses. Furthermore, the unplanned conversion to open radical or partial nephrectomy after an attempted minimally invasive approach has been an independent predictor of increased risk of 30-day hospital readmission. Currently, the relative risk factors to predict unplanned conversion to open surgery has not been well characterized. Greater understanding of risk factors for unplanned open conversion has clinical implications to reduce intraoperative and postoperative outcomes. The early recognition of nationwide risk and predictors may aid in identifying patients for planned open kidney surgery. We aim to use the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database to identify predictors and outcomes in a contemporary cohort.

 

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