The role of R.E.N.A.L. nephrometry score in the era of robot-assisted partial nephrectomy

Keng Siang Png, Clinton Bahler, Daniel P. Milgrom, Steven M. Lucas, Chandru Sundaram

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Purpose: We studied the role of the R.E.N.A.L. nephrometry score (NS) in predicting surgical outcomes in a series of robot-assisted partial nephrectomy (RAPN). Patients and Methods: Of 99 cases of minimally invasive partial nephrectomy performed by a single surgeon from 2003 to 2011, 83 were performed with robotic assistance. A trained physician investigator applied the NS to these 83 cases using the preoperative CT scans. Forty-two of these were reviewed by a urology resident to eliminate interobserver variation. Tumors were categorized into noncomplex (NS 4-6) or complex (NS 7-12) tumors, and perioperative outcomes were compared. Outcomes were also compared by each component of the NS. Perioperative outcomes were analyzed using chi-square tests and Mann-Whitney/Kruskal-Wallis tests. Univariate regression was used to analyze trends between nephrometry and outcomes. Results: Strong correlation was found between the two sets of NS (Spearman correlational coefficient 0.814, P<0.001). Comparing between noncomplex and complex tumors, statistical differences were found in operative time (181 min vs 215 min, P=0.028) and ischemia time (21 min vs 24 min, P=0.006). Complication rates, blood loss, conversion rate, and decrease in glomerular filtration rate were similar in both groups. On univariate regression analysis, only warm ischemia time showed a significant trend with the overall NS (P=0.007) and the location score (P=0.031). Conclusions: A high NS was not associated with clinically worse outcomes during RAPN. Such renal tumors can still be excised safely with robotic assistance without adverse long-term effects.

Original languageEnglish
Pages (from-to)304-308
Number of pages5
JournalJournal of Endourology
Volume27
Issue number3
DOIs
StatePublished - Mar 1 2013

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Nephrectomy
Robotics
Neoplasms
Warm Ischemia
Observer Variation
Urology
Chi-Square Distribution
Operative Time
Glomerular Filtration Rate
Ischemia
Regression Analysis
Research Personnel
Physicians
Kidney

ASJC Scopus subject areas

  • Urology

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The role of R.E.N.A.L. nephrometry score in the era of robot-assisted partial nephrectomy. / Png, Keng Siang; Bahler, Clinton; Milgrom, Daniel P.; Lucas, Steven M.; Sundaram, Chandru.

In: Journal of Endourology, Vol. 27, No. 3, 01.03.2013, p. 304-308.

Research output: Contribution to journalArticle

Png, Keng Siang ; Bahler, Clinton ; Milgrom, Daniel P. ; Lucas, Steven M. ; Sundaram, Chandru. / The role of R.E.N.A.L. nephrometry score in the era of robot-assisted partial nephrectomy. In: Journal of Endourology. 2013 ; Vol. 27, No. 3. pp. 304-308.
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