Association of Tumor Size, Location, RENAL, PADUA and Centrality Index Score with Perioperative Outcomes and Postoperative Renal Function
Association of Tumor Size, Location, RENAL, PADUA and Centrality Index Score with Perioperative Outcomes and Postoperative Renal Function
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DOI：
10.1016/j.juro.2012.07.043
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发表时间：
2012-11-01
影响因子：
6.6
通讯作者：
Crispen, Paul L.
中科院分区：
文献类型：
--
作者：
Bylund, Jason R.;Gayheart, Dustin;Crispen, Paul L.
目的：多种评分系统已被提出，以标准化的描述肾肿瘤的解剖特征。然而，目前还不清楚这些系统中的哪一个（如果有的话）是最有用的，或者是否有任何系统比简单地报告接受肾部分切除术的患者的肿瘤大小或位置更好。为了澄清这些问题，我们评估了肿瘤大小，位置，R. E. N. A.L.（半径/外生性/邻近收集系统/前/位置），PADUA（用于解剖学分类的术前方面和尺寸）和中心性指数评分与围手术期outcome.Materials和方法的相关性：2005年至2011年，对接受肾部分切除术的患者进行了术前影像学检查。R.E.N.A.L.根据这些系统的描述方案分配PADUA和中心性指数评分。每个变量和缺血时间，估计失血量，总手术时间和估计肾小球滤过率的变化之间的关联examined.Results：共162例患者被确定为平均肿瘤大小为3.1厘米（IQR 2.2至4.6）。中位估计失血量、缺血时间和总手术时间分别为200 ml（IQR 100 - 300）、24分钟（IQR 20 - 30）和211分钟（IQR 179 - 249）。发现每个评分系统与缺血时间具有统计学显著（p < 0.001）相关性，其中中心性指标系统显示出最强的相关性。此外，每个评分系统表现出更强的相关性，缺血时间比肿瘤大小或肿瘤location.Conclusions：每个评分系统优于肿瘤的大小和位置，并可能是有用的，当描述肾肿瘤的手术复杂性与肾部分切除术。
Purpose: Multiple scoring systems have been proposed to standardize the description of anatomical features of renal tumors. However, it remains unclear which of these systems, if any, is most useful, or whether any performs better than simply reporting tumor size or location in patients undergoing partial nephrectomy. To clarify these issues we evaluated the association of tumor size, location, R.E.N.A.L. (Radius/Exophytic/Nearness to collecting system/Anterior/Location), PADUA (Preoperative Aspects and Dimensions Used for an Anatomical classification) and centrality index scores with perioperative outcomes.Materials and Methods: Patients undergoing partial nephrectomy with available preoperative imaging were identified from 2005 to 2011. R.E.N.A.L., PADUA and centrality index scores were assigned according to the described protocols for those systems. Associations between each variable and ischemia time, estimated blood loss, total operative time and change in estimated glomerular filtration rate were examined.Results: A total of 162 patients were identified with a median tumor size of 3.1 cm (IQR 2.2 to 4.6). Median estimated blood loss, ischemia time and total operative time were 200 ml (IQR 100 to 300), 24 minutes (IQR 20 to 30) and 211 minutes (IQR 179 to 249), respectively. Each scoring system was found to have a statistically significant (p < 0.001) correlation with ischemia time, with the centrality index system showing the strongest correlation. Furthermore, each of the scoring systems showed a stronger correlation with ischemia time than tumor size or tumor location.Conclusions: Each scoring system outperformed tumor size and location, and may be useful when describing the surgical complexity of renal tumors treated with partial nephrectomy.