腫瘤接觸表面積可預測部分腎切除後非腫瘤部分之腎臟體積
張天佑、王又德
中國附醫泌尿科
Tumor contact surface area predict the non-tumor renal volume after partial nephrectomy
Tian-You Chang, Wang Yu Dai
Department of Urology, China Medical University Hospital, Taichung, Taiwan
Purpose:
We had proposed a mathematical formula to calculate contact surface area
between a tumor and renal parenchyma, and it had been proven to be highly correlated to the renal function after partial nephrectomy. This time, we will examine the applicability of using contact surface area to predict the resected renal volume after partial nephrectomy.
Materials and Methods:
We performed this retrospective study in patients who underwent partial nephrectomy between January 2012 and December 2018. Based on abdominopelvic computerized tomography or magnetic resonance imaging, we calculated the contact surface area using the formula (2*p*radius*depth) developed by integral calculus. We then evaluated the correlation between contact surface area and perioperative parameters, and compared contact surface area and R.E.N.A.L. (Radius/Exophytic/endophytic/Nearness to collecting system/Anterior/ Location) score in predicting pathological resected renal volume
Results:
Overall 55, 59, and 121 patients underwent partial nephrectomy with open, laparoscopic and robotic approaches, respectively.The mean tumor size are 5.3±3.2cm, 142 case(60%) are RCC in which 88 case(62.2%)are T1a. Average warm and cold ischemia time are 22min and 31min seperately. Spearman correlation analysis showed that contact surface area and R.E.N.A.L. score was significantly associated with resected renal volume (p <0.001 and 0.02 respectively). On multivariate analysis contact surface area significantly affected resected renal volume(p <0.006.)
Conclusions:
Using this simple mathematical method, contact surface area was an important perioperative parameter to perdict the resected renal volume. Compared to R.E.N.A.L. score, contact surface area was a better predictor of resected renal volume for partial nephrectomy.