Retroperitoneal Nephrometry Scoring System (RETRO) for Minimal-Invasive Partial Nephrectomy
Urology Journal,
Vol. 20 No. 05 (2023),
23 October 2023
,
Page 312-317
https://doi.org/10.22037/uj.v20i.7519
Abstract
Purpose: To propose a standardized scoring system of renal tumors suitable for partial nephrectomy based on
mini-invasiveness and retroperitoneal approach.
Materials and Methods: One-hundred and five patients in retroperitoneal group were prospectively enrolled from
January 2017 to December 2018. Perioperative characteristics of all patients were collected: age, gender, BMI,
preoperative blood test and imaging results, operation time (the time period starts from the skin incision to the final
skin closure), estimated blood lost, clamping time, complications within 30 days, American Society of Anesthesiologists (ASA) score, pathology. An algorithm was extracted, and it was used to predict the risk of complications.
Results: Symptoms, ASA score and RETRO score were significantly correlated to postoperative complications,
excluding tumor size, ischemia time and operation time. Adjusted RETRO points were an independent factor to
predict complication rate (p = 0.006). Limitation was that it did not analyze the relationship between the RETRO
score and the long-term outcomes.
Conclusion: The RETRO score simplifies the risk evaluation of partial nephrectomy for patients with renal tumor,
especially benefits those surgeries performed under robot-assisted laparoscope via retroperitoneal approach. The
new RETRO score system that we developed is a selection criterion to perform surgery via different approaches,
and an accurate system to evaluate the complexity during partial nephrectomy.
- Partial nephrectomy; Retroperitoneal nephrometry; surgical approach; score system; mini-invasive
How to Cite
References
Ljungberg B, Albiges L, Abu-Ghanem Y, et al. European Association of Urology Guidelines on Renal Cell Carcinoma: The 2019 Update. European urology. May 2019;75(5):799-810.
Westerman ME, Cheville JC, Lohse CM, et al. Long-Term Outcomes of Patients With Low Grade Cystic Renal Epithelial Neoplasms. Urology. Nov 2019;133:145-150.
Capitanio U, Terrone C, Antonelli A, et al. Nephron-sparing techniques independently decrease the risk of cardiovascular events relative to radical nephrectomy in patients with a T1a-T1b renal mass and normal preoperative renal function. European urology. Apr 2015;67(4):683-689.
Simone G, Tuderti G, Anceschi U, et al. Oncological outcomes of minimally invasive partial versus minimally invasive radical nephrectomy for cT1-2/N0/M0 clear cell renal cell carcinoma: a propensity score-matched analysis. World journal of urology. May 2017;35(5):789-794.
Mir MC, Derweesh I, Porpiglia F, Zargar H, Mottrie A, Autorino R. Partial Nephrectomy Versus Radical Nephrectomy for Clinical T1b and T2 Renal Tumors: A Systematic Review and Meta-analysis of Comparative Studies. European urology. Apr 2017;71(4):606-617.
Tuderti G, Brassetti A, Mastroianni R, et al. Expanding the limits of nephron-sparing surgery: Surgical technique and mid-term outcomes of purely off-clamp robotic partial nephrectomy for totally endophytic renal tumors. International journal of urology : official journal of the Japanese Urological Association. Apr 2022;29(4):282-288.
Chiruvella M, Ghouse SM, Tamhankar AS. "Polar flip" technique for transperitoneal laparoscopic partial nephrectomy - Evolution of a novel technique for posterior hilar tumors. Indian journal of urology : IJU : journal of the Urological Society of India. Jul-Sep 2019;35(3):230-231.
Kutikov A, Uzzo RG. The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. The Journal of urology. Sep 2009;182(3):844-853.
Ficarra V, Novara G, Secco S, et al. Preoperative aspects and dimensions used for an anatomical (PADUA) classification of renal tumours in patients who are candidates for nephron-sparing surgery. European urology. Nov 2009;56(5):786-793.
Simmons MN, Ching CB, Samplaski MK, Park CH, Gill IS. Kidney tumor location measurement using the C index method. The Journal of urology. May 2010;183(5):1708-1713.
Hakky TS, Baumgarten AS, Allen B, et al. Zonal NePhRO Scoring System: A Superior Renal Tumor Complexity Classification Model. Clin Genitourin Canc. Feb 2014;12(1):E13-E18.
Clavien PA, Sanabria JR, Strasberg SM. Proposed classification of complications of surgery with examples of utility in cholecystectomy. Surgery. May 1992;111(5):518-526.
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Annals of surgery. Aug 2004;240(2):205-213.
Davidiuk AJ, Parker AS, Thomas CS, et al. Mayo Adhesive Probability Score: An Accurate Image-based Scoring System to Predict Adherent Perinephric Fat in Partial Nephrectomy. European urology. Dec 2014;66(6):1165-1171.
Yanishi M, Kinoshita H, Koito Y, et al. Adherent Perinephric Fat Is a Surgical Risk Factor in Laparoscopic Single-Site Donor Nephrectomy: Analysis Using Mayo Adhesive Probability Score. Transplantation proceedings. Jan - Feb 2020;52(1):84-88.
Xia L, Wang X, Xu T, Guzzo TJ. Systematic Review and Meta-Analysis of Comparative Studies Reporting Perioperative Outcomes of Robot-Assisted Partial Nephrectomy Versus Open Partial Nephrectomy. Journal of endourology. Sep 2017;31(9):893-909.
Chang KD, Abdel Raheem A, Kim KH, et al. Functional and oncological outcomes of open, laparoscopic and robot-assisted partial nephrectomy: a multicentre comparative matched-pair analyses with a median of 5 years' follow-up. BJU international. Oct 2018;122(4):618-626.
Garisto J, Bertolo R, Dagenais J, et al. Robotic versus open partial nephrectomy for highly complex renal masses: Comparison of perioperative, functional, and oncological outcomes. Urologic oncology. Oct 2018;36(10):471 e471-471 e479.
Brassetti A, Anceschi U, Bertolo R, et al. Surgical quality, cancer control and functional preservation: introducing a novel trifecta for robot-assisted partial nephrectomy. Minerva urologica e nefrologica = The Italian journal of urology and nephrology. Feb 2020;72(1):82-90.
Simone G, Capitanio U, Tuderti G, et al. On-clamp versus off-clamp partial nephrectomy: Propensity score-matched comparison of long-term functional outcomes. International journal of urology : official journal of the Japanese Urological Association. Oct 2019;26(10):985-991.
Jung S, Min GE, Chung BI, Jeon SH. Risk factors for postoperative hemorrhage after partial nephrectomy. Korean journal of urology. Jan 2014;55(1):17-22.
Baumann C, Westphalen K, Fuchs H, Oesterwitz H, Hierholzer J. Interventional management of renal bleeding after partial nephrectomy. Cardiovascular and interventional radiology. Sep-Oct 2007;30(5):828-832.
- Abstract Viewed: 444 times
- 7519/pdf Downloaded: 279 times