Analysis in related factors of patients with non-functional renal tuberculosis transferring from retroperitoneal laparoscopic nephrectomy to open surgery in intraoperation

Objective To explore the related factors of patients with non-functional renal tuberculosis transferring from retroperitoneal laparoscopic nephrectomy to open surgery in intraoperation. Methods A total of 93 patients with non-functional renal tuberculosis underwent retroperitoneal laparoscopic nephrectomy were selected as research objects. The patients transferring from retroperitoneal laparoscopic nephrectomy to open nephrectomy due to severe adhesion of the surrounding tissues of the resected kidney were selected as study group, and those without surgery conversion were included in control group. The age, gender, body mass index(BMI), complicating with diabetes mellitus as well as hypertension, position of kidney excision, size, calcification, peripheral exudation of the resected kidney as well as contralateral hydronephrosis, the duration of preoperative antituberculosis treatment in the two groups were compared and analyzed. Results Twenty-one patients were converted to open nephrectomy, accounting for 22.58%. The BMI, the ratio of complicating with diabetes mellitus, ratio of diameter of resected kidney above 10 cm, and the ratio of duration of preoperative antituberculosis treatment ≤3 months in the study group were higher than those in the control group, the differences were statistically significant(P<0.05 or P<0.01). The results of Logistic multiple regression analysis showed that the conversion from retroperitoneal laparoscopic nephrectomy to open nephrectomy for - non-functional renal tuberculosis was correlated with complicating with diabetes mellitus, the size of resected kidney, the duration of preoperative antituberculosis treatment(P<0.01). Conclusion The conversion from retroperitoneal laparoscopic nephrectomy to open nephrectomy for non-functional renal tuberculosis is related to diabetes mellitus, the size of resected kidney, the duration of preoperative antituberculosis treatment. The clinicians should comprehensively evaluate and effectively intervene the related factors to enhance the success rate of laparoscopic nephrectomy, decrease the risk of conversion to open nephrectomy, and reduce surgical trauma.