700 HIGHER R.E.N.A.L. NEPHROMETRY SCORE IS PREDICTIVE OF LONGER WARM ISCHEMIA TIME AND COLLECTING SYSTEM ENTRY DURING LAPAROSCOPIC AND ROBOTIC-ASSISTED PARTIAL NEPHRECTOMY

Abstract

You have accessJournal of UrologyKidney Cancer: Evaluation and Staging1 Apr 2011700 HIGHER R.E.N.A.L. NEPHROMETRY SCORE IS PREDICTIVE OF LONGER WARM ISCHEMIA TIME AND COLLECTING SYSTEM ENTRY DURING LAPAROSCOPIC AND ROBOTIC-ASSISTED PARTIAL NEPHRECTOMY Wesley A. Mayer, Guilherme Godoy, Judy M. Choi, Alvin C. Goh, Shelly X. Bian, and Richard E. Link Wesley A. MayerWesley A. Mayer Houston, TX More articles by this author , Guilherme GodoyGuilherme Godoy Houston, TX More articles by this author , Judy M. ChoiJudy M. Choi Houston, TX More articles by this author , Alvin C. GohAlvin C. Goh Houston, TX More articles by this author , Shelly X. BianShelly X. Bian Houston, TX More articles by this author , and Richard E. LinkRichard E. Link Houston, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1667AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The RENAL Nephrometry Score (NS) was proposed as a system to describe and quantify the most surgically relevant anatomical features of solid renal masses and to provide a means to compare surgical series (Kutikov and Uzzo, J Urol, Sept 2009). Interest in NS has grown rapidly with over 15 accepted abstracts and 2 peer-reviewed publications examining the scoring system. We report the largest series to date investigating the predictive value of nephrometry score on operative outcomes during laparoscopic (LPN) and robotic-assisted partial nephrectomy (RPN). METHODS We performed a retrospective review of 67 consecutive patients with suspicious renal lesions and available NSs who underwent LPN or RPN from February 2008 to August 2010 by a single surgeon. Data included operative type, BMI, gender, age, and side of tumor. NSs were recorded using either magnetic resonance imaging or computed tomography as previously described. Operative type was classified as either RPN with enucleation, RPN by standard resection, and LPN by standard resection. Warm ischemia time (WIT), estimated blood loss (EBL), and collecting system entry (CSE) were the endpoints for the analyses. Besides comparisons of continuous variables (WIT and EBL) and proportion of CSE, we used linear and logistic regression models for analyses. RESULTS Total NS used either as a numerical or categorical variable (< 7 or ≥7), the “R” score, and the “N” score were independent predictors of WIT after controlling for operative type, BMI, age, laterality, and gender (p < 0.001, p = 0.001, p = 0.026, and p <0.01, respectively). There was no significant difference in the median WIT between the “N” scores N=2 and N=3. The “N” score was predictive of CSE in univariate analysis (p < 0.001). The total NS coded either as a numerical or categorical variable was also an independent predictor of CSE after controlling for operative type (p < 0.001 and p < 0.001, respectively). None of the individual parameters of the NS nor the total NS were predictive of EBL. There was only 1 positive margin in a patient with a NS of 7xh. CONCLUSIONS Total nephrometry score (either as a numerical value or using a cutoff of “7”) as well as the “N” score were independent predictors of both longer warm ischemia time and collecting system entry during LPN and RPN. The “R” score was also an independent predictor of longer warm ischemia time. The nephrometry score and its individual components may be useful in the preoperative evaluation and counseling of patients undergoing LPN or RPN. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e281-e282 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Wesley A. Mayer Houston, TX More articles by this author Guilherme Godoy Houston, TX More articles by this author Judy M. Choi Houston, TX More articles by this author Alvin C. Goh Houston, TX More articles by this author Shelly X. Bian Houston, TX More articles by this author Richard E. Link Houston, TX More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...