RENAL 腎臟腫瘤評分系統在預測腹腔鏡部分腎臟切除手術之單一機構外部效度評估
吳振宇1、陳毓騏1、盧嘉文1、黃景榆1、凌永耀1、林嘉祥1, 2
1.義大醫院醫院 泌尿科1; 2.義守大學 後中醫學系2
External Validation of RENAL Nephrometry Score to Access the Perioperative Parameter for Laparoscopic Partial Nephrectomy in a Single Institution
Chen-Yu Wu1, Yu-Chi Chen1, Kevin Lu1, Ching-Yu Huang1, Henry Y. Lin1, Victor C. Lin1, 2
1. Department of Urology, E-Da Hospital, Kaohsiung, Taiwan;
2. School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan
Purpose:
RENAL Nephrometry Score (RNS) has been proposed as an anatomical classification system for renal masses to investigate the influence on perioperative outcomes and complications. The aim of this study was to assess the system for external validation.
Materials and Methods:
The single-surgeon database enrolled patients who had undergone laparoscopic partial nephrectomy by either retroperitoneal or transperitoneal approaches from December 2008 to September 2013, had been proved by IRB. Exclusion criteria is combined surgery. Renal tumors were categorized by RNS sum score as low (4–6), intermediate (7–9) and high (10–12). We reviewed peri-operative outcomes including operation time (OT), length of saty (LOS), estimated blood loss (EBL), ischemic time, either is cold or warm, need of blood transfusion during operation. Post-operative complications were categorized by the modified Clavien-Dindo classification system. The data was collected retrospective and analyzed by PASW ver. 18.0.
Results:
Total 53 patients were enrolled mean age 49.9 ± 13.52. Of the 53 patients, there were 15 low, 26 intermediate and 12 high score lesions. There was no statistically significant difference in the demographics of the three groups. Total complication rate (22.5%vs26.6%vs31.5%; trend P=0.017) and grade 3 complication rate (24%vs26%vs31%; trend P=0.082) had significant difference between low, intermediate and high score groups, respectively. There was no statistic difference in operative time (trend P=0.403), ischemia time (19.2vs24.9vs24.4; trend P=0.427), EBL (trend P=0.883), transfusion rate (trend P=0.5), and LOS (trend P=0.206).
Conclusions:
The RNS may categorize tumors based on the technical difficulty of performing LPN when predict complication rate, especially high grade complications. The others parameters have trend difference but not achieved statistic difference.