Nefron Koruyucu Cerrahide Yüzey, Ara ve Taban Skorlama Sisteminin Klinikopatolojik Bulgular ile Karşılaştırılması

Abstract

A surface, intermediate, and base scoring system has been developed by an international consortium to establish a relationship between complication rates, surgical margin status, preserved parenchyma volume and oncologic outcomes with resection method in nephron sparing surgery. In this study, the relationship between the surface, intermediate, and base scoring of the patients with nephron-sparing surgery and clinical findings were evaluated. The data of 80 patients who underwent partial nephrectomy by the same surgeon between 2015-2017 were prospectively examined. During the surgery, the resection surface facing the tumor floor of removed unprocessed bulk was divided into 3 sections, surface - intermediate - base and scored as proximity to the mass. The duration of ischemia during surgery, perioperative complications, pathologic evaluations and follow-up periods were recorded. The data were analyzed in SPSS 20.0 with univariate and multivariate analysis. Male to female ratio was: 55/25. Mean age and body mass index were 58 (29-86) years and 27.8 kg/m², respectively. The mean renal mass size was 3.69 cm. Of all, 11.3% had multiple renal masses. The residual volume calculated before and after the surgery were significant when compared with the SIB score (p=0.005). Low base score was associated with positive surgical margins (p= 0.017). Gender, age, surgical side, GFR change, hospital stay, drain withdrawal period, complications, surgical margin status, ischemia time and trifecta showed no significant difference in univariate analysis. Surface, intermediate, base scoring system is useful and easy method for classifying and standardizing the technique of resection in nephron-sparing surgery. Our early results show that, SIB scoring system predicts the excised and remained parenchyma after the surgery. Besides, low base score was associated with positive surgical margins. However, to better evaluate the relationship between oncological and functional outcomes, multi-centered and more comprehensive studies are needed.