Application of R.E.N.A.L. nephrometry score for transperitoneal laparoscopic partial nephrectomy in renal tumor of T1a stage

doi:10.3877/cma.j.issn.1674-3253.2018.01.014

Abstract

Abstract:

Objective

To evaluate R.E.N.A.L. nephrometry score for transperitoneal laparoscopic partial nephrectomy (TLPN).

Methods

Between July 2010 and October 2016, 67 cases (52 males and 15 females) underwent TLPN. Mean age was (56±13) years, mean tumor size was (2.5 ± 0.8) cm in diameter, 32 cases (48%) on the left side and 35 cases (52%) on the right side. R.E.N.A.L. nephrometry score were evaluated in tumor size, warm ischemia time, intraoperative blood loss, operation time, preoperative and postoperative creatinine and hospitalization days.

Results

Sixty-seven patients were successfully completed TLPN, no conversion to open surgery and deaths. Mean R.E.N.A.L.score was (6.3± 1.7). 37 cases(55%), 24 cases(36%) and 6 cases(9%) were enrolled in low, moderate and high score group, respectively. There were significant differences between patients of different R.E.N.A.L.score groups in tumor size (F=5.230, P=0.008). There was no difference in warm ischemia time, intraoperative blood loss, operation time, preoperative and postoperative creatinine and hospitalization days (P>0.05).

Conclusions

In patients with T1a kidney tumor undergoing TLPN, the value of R.E.N.A.L. nephrometry score is limited in clinical application.

Key words: R.E.N.A.L.nephrometry score, Laparoscopy, Partial nephrectomy, Renal tumor

Qiang Hao, Peng Xue, Huantao Zong, Yong Zhang. Application of R.E.N.A.L. nephrometry score for transperitoneal laparoscopic partial nephrectomy in renal tumor of T1a stage[J]. Chinese Journal of Endourology(Electronic Edition), 2018, 12(01): 53-56.

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References 22

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项目	评分
项目	1分	2分	3分
（R）最大径（cm）	≤4	4<R<7	≥7
（E）肿瘤外凸率	≥50%	<50%	完全在肾实质内
（N）与集合系统的距离（mm）	≥7	4<N<7	≤4
（A）腹侧/背侧	无分值，标注为A(腹侧)、P(背侧)、X(腹侧／背侧)
（L）相对于肾极线的位置	完全位于极线的上方或下方	极线穿过肿瘤	通过极线>50%；通过极间线；完全位于上下极线间

项目	评分
项目	1分	2分	3分
（R）最大径（cm）	≤4	4<R<7	≥7
（E）肿瘤外凸率	≥50%	<50%	完全在肾实质内
（N）与集合系统的距离（mm）	≥7	4<N<7	≤4
（A）腹侧/背侧	无分值，标注为A(腹侧)、P(背侧)、X(腹侧／背侧)
（L）相对于肾极线的位置	完全位于极线的上方或下方	极线穿过肿瘤	通过极线>50%；通过极间线；完全位于上下极线间

分组	例数	年龄（岁）	肿瘤最大径（cm）	热缺血时间（min）	术中出血量[M（Q），ml]	手术时间（min）	术前肌酐（μmol/l）	术后肌酐（μmol/l）	住院天数（d）
低评分组	37	55±12	2.2±0.8	25±16	100（225）	158±58	75±15	95±30	17±60
中评分组	24	58±13	3.1±1.3	30±70	200（315）	188±50	75±14	94±17	22±14
高评分组	6	49±21	2.7±1.3	36±90	100（312）	174±26	66±21	77±24	23±12
F／χ²值	?	1.037	5.230	2.119	χ²=0.961	2.355	0.966	1.315	2.032
P值	?	0.360	0.008	0.128	0.618	0.103	0.386	0.276	0.139

分组	例数	年龄（岁）	肿瘤最大径（cm）	热缺血时间（min）	术中出血量[M（Q），ml]	手术时间（min）	术前肌酐（μmol/l）	术后肌酐（μmol/l）	住院天数（d）
低评分组	37	55±12	2.2±0.8	25±16	100（225）	158±58	75±15	95±30	17±60
中评分组	24	58±13	3.1±1.3	30±70	200（315）	188±50	75±14	94±17	22±14
高评分组	6	49±21	2.7±1.3	36±90	100（312）	174±26	66±21	77±24	23±12
F／χ²值	?	1.037	5.230	2.119	χ²=0.961	2.355	0.966	1.315	2.032
P值	?	0.360	0.008	0.128	0.618	0.103	0.386	0.276	0.139

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