Predicting outcomes in partial nephrectomy: is the renal score useful?
ABSTRACT Introduction and Objective The R.E.N.A.L. nephrometry system (RNS) has been validated in multiple open, laparoscopic and robotic partial nephrectomy series. The aim of this study was to test the accuracy of R.E.N.A.L. nephrometry system in predicting perioperative outcomes in surgical tre...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Urologia
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| Series: | International Brazilian Journal of Urology |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382017000300422&lng=en&tlng=en |
| _version_ | 1811307936600817664 |
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| author | André Costa Matos Marcos F. Dall´Oglio José Roberto Colombo Jr Alexandre Crippa João A. Q. Juveniz Felipe Coelho Argolo |
| author_facet | André Costa Matos Marcos F. Dall´Oglio José Roberto Colombo Jr Alexandre Crippa João A. Q. Juveniz Felipe Coelho Argolo |
| author_sort | André Costa Matos |
| collection | DOAJ |
| description | ABSTRACT Introduction and Objective The R.E.N.A.L. nephrometry system (RNS) has been validated in multiple open, laparoscopic and robotic partial nephrectomy series. The aim of this study was to test the accuracy of R.E.N.A.L. nephrometry system in predicting perioperative outcomes in surgical treatment of kidney tumors <7.0cm in a prospective model. Materials and Methods Seventy-one patients were selected and included in this prospective study. We evaluate the accuracy of RNS in predicting perioperative outcomes (WIT, OT, EBL, LOS, conversion, complications and surgical margins) in partial nephrectomy using ROC curves, univariate and multivariate analyses. R.E.N.A.L. was divided in 3 groups: low complexity (LC), medium complexity (MC) and high complexity (HC). Results No patients in LC group had WIT >20 min, versus 41.4% and 64.3% MC and HC groups respectively (p=0.03); AUC=0.643 (p=0.07). RNS was associated with convertion rate (LC:28.6% ; MC:47.6%; HC:77.3%, p=0.02). Patients with RNS <8 were most often subjected to partial nephrectomy (93% x 72%, p=0.03) and laparoscopic partial nephrectomy (56.8% x 28%, p=0.02), AUC=0.715 (p=0.002). The RNS was also associated with operative time. Patients with a score >8 had 6.06 times greater chance of having a surgery duration >180 min. (p=0.017), AUC=0.63 (p=0.059). R.E.N.A.L. score did not correlate with EBL, complications (Clavien >3), LOS or positive surgical margin. Conclusion R.E.N.A.L. score was a good method in predicting surgical access route and type of nephrectomy. Also was associated with OT and WIT, but with weak accuracy. Although, RNS was not associated with Clavien >3, EBL, LOS or positive surgical margin. |
| first_indexed | 2024-04-13T09:13:13Z |
| format | Article |
| id | doaj.art-3f9befe58dcf4b27ac5f3f8ca0b07598 |
| institution | Directory Open Access Journal |
| issn | 1677-6119 |
| language | English |
| last_indexed | 2024-04-13T09:13:13Z |
| publisher | Sociedade Brasileira de Urologia |
| record_format | Article |
| series | International Brazilian Journal of Urology |
| spelling | doaj.art-3f9befe58dcf4b27ac5f3f8ca0b075982022-12-22T02:52:49ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-611943342243110.1590/s1677-5538.ibju.2016.0315S1677-55382017000300422Predicting outcomes in partial nephrectomy: is the renal score useful?André Costa MatosMarcos F. Dall´OglioJosé Roberto Colombo JrAlexandre CrippaJoão A. Q. JuvenizFelipe Coelho ArgoloABSTRACT Introduction and Objective The R.E.N.A.L. nephrometry system (RNS) has been validated in multiple open, laparoscopic and robotic partial nephrectomy series. The aim of this study was to test the accuracy of R.E.N.A.L. nephrometry system in predicting perioperative outcomes in surgical treatment of kidney tumors <7.0cm in a prospective model. Materials and Methods Seventy-one patients were selected and included in this prospective study. We evaluate the accuracy of RNS in predicting perioperative outcomes (WIT, OT, EBL, LOS, conversion, complications and surgical margins) in partial nephrectomy using ROC curves, univariate and multivariate analyses. R.E.N.A.L. was divided in 3 groups: low complexity (LC), medium complexity (MC) and high complexity (HC). Results No patients in LC group had WIT >20 min, versus 41.4% and 64.3% MC and HC groups respectively (p=0.03); AUC=0.643 (p=0.07). RNS was associated with convertion rate (LC:28.6% ; MC:47.6%; HC:77.3%, p=0.02). Patients with RNS <8 were most often subjected to partial nephrectomy (93% x 72%, p=0.03) and laparoscopic partial nephrectomy (56.8% x 28%, p=0.02), AUC=0.715 (p=0.002). The RNS was also associated with operative time. Patients with a score >8 had 6.06 times greater chance of having a surgery duration >180 min. (p=0.017), AUC=0.63 (p=0.059). R.E.N.A.L. score did not correlate with EBL, complications (Clavien >3), LOS or positive surgical margin. Conclusion R.E.N.A.L. score was a good method in predicting surgical access route and type of nephrectomy. Also was associated with OT and WIT, but with weak accuracy. Although, RNS was not associated with Clavien >3, EBL, LOS or positive surgical margin.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382017000300422&lng=en&tlng=enNephrectomyOperative TimePatients |
| spellingShingle | André Costa Matos Marcos F. Dall´Oglio José Roberto Colombo Jr Alexandre Crippa João A. Q. Juveniz Felipe Coelho Argolo Predicting outcomes in partial nephrectomy: is the renal score useful? International Brazilian Journal of Urology Nephrectomy Operative Time Patients |
| title | Predicting outcomes in partial nephrectomy: is the renal score useful? |
| title_full | Predicting outcomes in partial nephrectomy: is the renal score useful? |
| title_fullStr | Predicting outcomes in partial nephrectomy: is the renal score useful? |
| title_full_unstemmed | Predicting outcomes in partial nephrectomy: is the renal score useful? |
| title_short | Predicting outcomes in partial nephrectomy: is the renal score useful? |
| title_sort | predicting outcomes in partial nephrectomy is the renal score useful |
| topic | Nephrectomy Operative Time Patients |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382017000300422&lng=en&tlng=en |
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