Böbrek Kitleleri Nedeniyle Parsiyel Nefrektomi Yapılan Hastalarda Nefrometri Skorlarının İntraoperatif ve Postoperatif Sonuçları Öngörmedeki Yeri

Abstract

Nephrometry scores of 162 partial nephrectomy patients with the diagnosis of renal tumor between 2012 and 2017 were retrospectively analyzed. The prediction value of nephrometry scores on intraoperative and postoperative outcomes were investigated. The data was analyzed by using SPSS 24.0 program. Of the patients, 35.8% were females and 64.2% were males, the mean age was 55.2 ± 12.7 years, median duration of follow up was 15 (1-73) months. Median R.E.N.A.L. score was found to be 6 (4-11), PADUA score was found to be 8 (6-13) and DAP score was 6 (3-9). A positive correlation was found between R.E.N.A.L., PADUA, DAP scores and ischemia time (p=0.005, p=0.001, p=0.007, respectively). R.E.N.A.L. score was significant for intraoperative complication development and trifecta failure in multivariate analysis; and also significant for perioperative transfusion need and nephrectomy need in univariate analysis (p=0.002, p<0.001, p=0.006, p<0.001, respectively). PADUA score was significant for intraoperative complications, nephrectomy and perioperative transfusion in univariate analysis (p<0.001, p<0.001, p=0.028, respectively). DAP score was significant for intraoperative complications and nephrectomy in univariate analysis (p=0.018, p=0.001, respectively). If the tumor was exophytic, more than 50% of its size, there was no need for ischemia (p>0.001). Being in high risk group according to R.E.N.A.L. score and having a tumor larger than 4 cm were important for intraoperative complications (p=0.002, p=0.022, respectively). Preoperative GFR<60 was found to be a significant factor for postoperative complication (p=0.031). Tumors larger than 4 cm was the only factor which predicts nephrectomy (p=0.025). Being in high risk group according to R.E.N.A.L. score was important for trifecta failure and open partial nephrectomy was the only factor which predicted the pentafecta failure (p<0.001, p=0.026, respectively). Nephrometry scores are easy and feasible factors for the prediction of intraoperative complications and showing that the tumor is suitable for partial nephrectomy as well.