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Usefulness of the diameter-axial-polar nephrometry score for predicting perioperative parameters in robotic partial nephrectomy.

 Young Eun Yoon  ;  Kyung Hwa Choi  ;  Kwang Suk Lee  ;  Kwang Hyun Kim  ;  Koon Ho Rha  ;  Young Deuk Choi  ;  Woong Kyu Han 
 WORLD JOURNAL OF UROLOGY, Vol.33(6) : 841-845, 2015 
Journal Title
Issue Date
Adult ; Anthropometry ; Blood Loss, Surgical/statistics & numerical data ; Carcinoma, Renal Cell/diagnostic imaging ; Carcinoma, Renal Cell/pathology* ; Carcinoma, Renal Cell/surgery ; Cohort Studies ; Female ; Glomerular Filtration Rate ; Humans ; Kidney/diagnostic imaging ; Kidney/pathology* ; Kidney Neoplasms/diagnostic imaging ; Kidney Neoplasms/pathology* ; Kidney Neoplasms/surgery ; Laparoscopy ; Linear Models ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Nephrectomy* ; Organ Size ; Postoperative Complications/epidemiology* ; Renal Insufficiency, Chronic/epidemiology* ; Retrospective Studies ; Robotic Surgical Procedures ; Severity of Illness Index ; Tomography, X-Ray Computed ; Treatment Outcome ; Tumor Burden ; Warm Ischemia/statistics & numerical data
Renal cell carcinoma ; Nephrometry ; Partial nephrectomy ; Renal function
PURPOSE: The present study aimed to verify the association between diameter-axial-polar (DAP) nephrometry and surgical outcomes, postoperative renal function, and perioperative complications in patients undergoing robotic partial nephrectomy (RPN).
METHODS: Diameter-axial-polar nephrometry was assessed using computed tomography or magnetic resonance imaging on 158 patients who received RPN between July 2007 and February 2013. Demographic data, surgical data, and perioperative complications were recorded, and percent change between the preoperative and last estimated glomerular filtration rate (eGFR) was determined. Linear regression analysis was conducted to assess the relationship between the DAP sum score and warm ischemia time (WIT), estimated blood loss (EBL), and percent decrease in eGFR. Multivariable linear regression analysis was conducted to determine the relationship between each DAP scoring parameter and surgical outcomes.
RESULTS: The median patient age was 50.5 years and median DAP sum score was 6. On linear regression, the DAP sum score was associated with WIT and EBL. On multivariable regression, all DAP parameters were associated with WIT, but the polar distance was not associated with EBL. Patients with a higher DAP sum score showed greater decrease in eGFR after RPN. Patients with a DAP sum score of 6 or higher had a higher risk of major complications than those with a DAP sum score below 6.
CONCLUSIONS: Diameter-axial-polar nephrometry predicted WIT and EBL in patients who underwent RPN. It was also associated with the decrease in eGFR and rate of major perioperative complications, and thus can be useful for surgical planning or patient counseling before RPN.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Yoon, Young Eun(윤영은)
Lee, Kwang Suk(이광석) ORCID logo https://orcid.org/0000-0002-7961-8393
Choi, Kyung Hwa(최경화)
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Han, Woong Kyu(한웅규) ORCID logo https://orcid.org/0000-0002-2527-4046
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