| Objective to observe the preoperative clinical data and surgerical outcome in renal tumor patients,to investigate the relationship between intraoperative operation method conversion in renal tumor patients and the many objective factors, summarize the clinical significance, help to develop clinical work.Methods From June 2012 to June 2015,in the department of urology of the First Affiliated Hospital of Soochow University, the clinical data of 39 cases undergoing intraoperative operation method conversion and 328 cases.of not were analyzed retrospectively.The former one after selected was divided into four groups, including 16 cases of laparoscopic partial nephrectomy(LAPNSS) to laparoscopic radical nephrectomy(LAPRN),10 cases of laparoscopic radical nephrectomy(LAPRN) to radical nephrectomy(RN), 7 cases of laparoscopic partial nephrectomy(LAPNSS) to open partial nephrectomy(NSS), 6 cases of open partial nephrectomy(NSS) to radical nephrectomy(RN). The latter one(288 cases)after selected was divided into three groups, including 145 cases of LAPNSS,117 cases of LAPRN, 26 cases of NSS.Use t-test,chi-square test,FISH test and the logistic regression analysis to find the relationship between the causes of intraoperative operation method conversion and the objective factors,including the patients’ ages, BMI, tumor sizes, R.E.N.A.L.nephrometry score(RNS).Results The t-test, chi-square test or Fish test shows: there are significant differences between the LAPNSS group undergoing intraoperative operation method conversion and the LAPNSS group undergoing not in the tumor size, RNS,intraoperative tenacity(P<0.05);there are significant differences between the LAPRN group undergoing intraoperative operation method conversion and the LAPRN group undergoing not in the intraoperative tenacity and tumor size(P<0.05);there are no differences between two kinds of NSS in the relational factors(P>0.05);there are significant differences between the group LAPNSS to LAPRN and the group LAPNSS to NSS in the intraoperative tenacity(P<0.05);Multiariable logistic regression analysis shows that RNS and the intraoperative tenacity are associated with operation method conversion in LAPNSS surgery;the intraoperative tenacity is associated with operation method conversion in LAPRN surgery.Conclusion Laparoscopic nephrectomy surgery,with long learning time,requires high surgerical technology and is easily affected by objective factors.For some patients,the causes of intraoperative operation method conversion are associated with objective factors,including large tumor size,serious intraoperative tenacity.On the evaluation of RENAL tumors’ anatomical characteristics,RNS has a certain clinical significance, can provide a thought for clinicians in operation choice of nephron-sparing surgery. |
