Analysis of Influencing Factors of Conversion from Robot-Assisted Partial Nephrectomy to Radical Nephrectomy

ObjectiveTo analyze the influencing factors of conversion from robot-assisted partial nephrectomy (RAPN) to radical nephrectomy (RN). MethodsThe clinical data and surgical records of 258 patients who underwent RAPN at Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province from January 2021 to November 2025 were retrospectively collected. The patients were divided into the conversion group and the non-conversion group based on whether the operation was converted to RN intraoperatively. The relevant clinical data of the two groups were compared, and the reasons and influencing factors for conversion to RN were analyzed. ResultsOf the 258 patients, 8 (3.1%) were converted to RN. The reasons for conversion from RAPN to RN include: complicated tumor anatomy and technical difficulty; suspicion of locally advanced renal tumor intraoperatively; severe intraoperative bleeding. Univariate analysis showed that the R.E.N.A.L score (P<0.001), renal hilar tumor (P<0.001) and T stage (P=0.002) were the influencing factors for conversion to RN. ConclusionThe main reasons for conversion from RAPN to RN are complex tumor anatomy, suspicion of locally advanced renal tumors intraoperatively, and severe intraoperative bleeding. The R.E.N.A.L score, renal hilar tumor location, and T stage are the influencing factors for conversion from RAPN to RN. Funding informationResearch Fund Project of the Hebei Provincial Health Commission (20240915)