To investigate the value of DDD scoring system in retroperitoneoscopic partial nephrectomy for patients with renal cell carcinoma to estimate the tumor complexity, surgical difficulty and risk of complications.

The clinical data of 51 patients with renal cell carcinoma who underwent retroperitoneoscopic partial nephrectomy from January 2015 to October 2019 were collected. The patients were divided into low-grade complex group, moderate-complex group and high-complex group according to DDD scoring system. The age, gender, tumor location, body mass index (BMI), operation time, intraoperative warm ischemia time, intraoperative blood loss, preoperative and postoperative serum creatinine difference, postoperative hospital stay and complications were collected and compared among the three groups.

Of the 51 patients, 21 cases were in the low-grade complex group, 15 cases were in the moderate-complex group, and 15 cases were in the high-grade complex group. There was no statistically significant difference in age, gender, tumor location and BMI among the three groups (P>0.05). The average operation time was (74.6±13.1) min, (88.0±31.5) min and (111.0 ±25.0) min, the average intraoperative warm ischemia time was (10.4±1.8) min, (13.0±2.9) min and (20.6 ± 5.6) min, and the average intraoperative blood loss was (47.1±27.2) ml, (56.0±26.7) ml and (68.0±20.1) ml, respectively. The higher the DDD score, the blood loss was more, the warm ischemia time was longer, and the operation time was longer (P<0.05). The mean postoperative increase of serum creatinine in each group was (4.8±6.7) μmol/L, (10.2 ±4.9) μmol/L and (10.6±5.3) μmol/L, respectively, and the mean postoperative hospital stay was (6.7±0.9) d, (10.4 ±5.6) d and (10.4±2.1) d, respectively. Compared with the other two groups, the postoperative change of serum creatinine was small and the postoperative hospital stay was short, and the differences had statistical significance (P<0.05). In addition, the risk of postoperative complications was 3.65 times higher in the highly complex group than in the low-complex group (P<0.05), and the DDD scoring system had a higher accuracy in predicting the occurrence of postoperative complications (AUC=0.894).

DDD scoring system in retroperitoneoscopic partial nephrectomy for renal cell carcinoma has a good clinical value in predicting the complexity of the tumor, the difficulty of surgery and the risk of postoperative complications.