624 APPLICATION OF R.E.N.A.L. NEPHROMETRY SCORE TO LAPAROSCOPIC PARTIAL NEPHRECTOMY

Abstract

You have accessJournal of UrologyKidney Cancer: Advanced II1 Apr 2010624 APPLICATION OF R.E.N.A.L. NEPHROMETRY SCORE TO LAPAROSCOPIC PARTIAL NEPHRECTOMY Matthew Hayn, Thomas Schwaab, Willie Underwood, and Hyung Kim Matthew HaynMatthew Hayn Buffalo, NY More articles by this author , Thomas SchwaabThomas Schwaab Buffalo, NY More articles by this author , Willie UnderwoodWillie Underwood Buffalo, NY More articles by this author , and Hyung KimHyung Kim Los Angeles, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.960AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The R.E.N.A.L. Nephrometry Score (NS) has been proposed as a standardized anatomical classification system for renal masses. The score is based on 5 anatomical characteristics of the tumor: Radius (maximal diameter), Exophytic/endophytic properties, Nearness to collecting system or renal sinus, Anterior versus posterior descriptor, and Location relative to polar line. The purpose of this study was to assess the utility of the R.E.N.A.L.-NS for patients undergoing laparoscopic partial nephrectomy (LPN). METHODS We reviewed 159 consecutive patients who underwent LPN by a single surgeon at one institution, and R.E.N.A.L. scores were calculated for 141 patients with solitary renal masses who had complete radiographic data. Patients were divided into low (nephrometry sum 4-6), moderate (sum 7-9), and high (sum 10-12) complexity lesions as well as anterior versus posterior. Preoperative, intraoperative, pathologic, and postoperative outcomes were compared for the groups. RESULTS Of the 141 patients, there were 43 (30%) low complexity, 91 (65%) moderate complexity, and 7 (5%) high complexity lesions. Sixty-one lesions (43%) were anterior and 80 (57%) were posterior. There was no statistically significant difference in the demographics of the three groups. No difference was found among any intraoperative, pathologic, or postoperative outcomes when comparing anterior versus posterior lesions. There was a significant difference in warm ischemia time (16 vs 23 vs 31 minutes, p<0.0001), estimated blood loss (163 vs 312 vs 317 mL, p=0.034), and hospital length of stay (1.2 vs 1.9 vs 2.3 days, p<0.0001) between the low, moderate, and high complexity groups, respectively. There was no difference in overall operative time (p=0.862), transfusion rate (p=0.665), complication rate (p=0.419), preoperative creatinine clearance (p=0.888), or postoperative creatinine clearance (p=0.473) between the groups. There was no statistically significant difference in pathologic characteristics between the groups. CONCLUSIONS In patients undergoing LPN, a higher R.E.N.A.L. Nephrometry Score was significantly associated with an increased estimated blood loss, warm ischemia time, and length of hospital stay. The R.E.N.A.L.-NS may be helpful in counseling patients and may stratify tumors based on the technical difficulty of performing LPN. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e245 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Matthew Hayn Buffalo, NY More articles by this author Thomas Schwaab Buffalo, NY More articles by this author Willie Underwood Buffalo, NY More articles by this author Hyung Kim Los Angeles, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...