The Nephrometry Score: Is It Effective for Predicting Perioperative Outcome During Robot-Assisted Partial Nephrectomy?
연재승, Son Seung-Jun, 이영주, 차우헌, 최원석, 정진우, 이병기, 이상철, 정창욱, 홍성규, 변석수, 이상은,
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연재승 ( Yeon Jae-Seung )
Seoul National University College of Medicine Seoul National University Hospital Department of Urology
( Son Seung-Jun )
Seoul National University Hospital Department of Urology
이영주 ( Lee Young-Ju )
Seoul National University Hospital Department of Urology
차우헌 ( Cha Woo-Heon )
Seoul National University Bundang Hospital Department of Urology
최원석 ( Choi Won-Suk )
Yongin Choi Urology Clinic
정진우 ( Chung Jin-Woo )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology
이병기 ( Lee Byung-Ki )
Seoul National University Bundang Hospital Department of Urology
이상철 ( Lee Sang-Chul )
Seoul National University Bundang Hospital Department of Urology
정창욱 ( Jeong Chang-Wook )
Seoul National University Bundang Hospital Department of Urology
홍성규 ( Hong Sung-Kyu )
Seoul National University Bundang Hospital Department of Urology
변석수 ( Byun Seok-Soo )
Seoul National University Bundang Hospital Department of Urology
이상은 ( Lee Sang-Eun )
Seoul National University Bundang Hospital Department of Urology
KMID : 0358320140550040254
Abstract
Purpose: Robot-assisted partial nephrectomy (RPN) has emerged as an alternative treatment for the management of small renal masses. This study was designed to investigate parameters that predict perioperative outcomes during RPN.
Materials and Methods: We retrospectively reviewed the medical records of 113 patients who underwent RPN between September 2008 and May 2012 at the Seoul National University Bundang Hospital. Clinical parameters, including warm ischemia time (WIT), estimated blood loss (EBL), and R.E.N.A.L and PADUA scores, were evaluated to predict perioperative outcomes.
Results: Of the 113 patients, 81 were men and 32 were women. The patients’ mean age was 53.5 years, and their mean body mass index was 22.3 kg/m2. Age, gender, and mass laterality had no effect on perioperative complications, WIT, or EBL. Univariate analysis revealed that a distance between the tumor and the collecting system of ≤4 mm or a renal mass size of >4 cm were associated with adverse profiles of complications, WIT, and EBL. However, multivariate analysis showed no association between the predictive parameters and tumor complexity as assessed by nephrometry scores. Tumor size of >4 cm increased the risk of blood loss >300 mL (odds ratio [OR], 3.5; 95% confidence interval [CI], 1.3.9.7; p=0.016). A distance between the tumor and the collecting system of ≤4 mm was associated with increased risk of WIT exceeding 20 minutes (OR, 2.8; 95% CI, 1.3.6.3; p=0.012).
Conclusions: Tumor size and proximity of the mass to the collecting system showed significant associations with EBL and WIT, respectively, during RPN. The R.E.N.A.L and PADUA nephrometry scoring systems did not predict perioperative outcomes.
키워드
Nephrectomy; Renal cell carcinoma; Robotics; Surgical blood loss; Warm ischemia
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