Can RENAL and PADUA Nephrometry Indices Predict Complications of Laparoscopic Cryoablation for Clinical Stage T1 Renal Tumors?

作者：Brunolf W. Lagerveld, Machteld Brenninkmeijer, Johan A. Van der Zee, Ernst P. van Haarst · 发表于：Journal of Endourology · 年份：2013 · DOI：10.1089/end.2013.0498 · 被引用次数：23 · 研究领域：Renal cell carcinoma treatment、Kidney Stones and Urolithiasis Treatments、Hepatocellular Carcinoma Treatment and Prognosis

OBJECTIVE: Assessment of anatomical complexity with the RENAL (radius; exophytic/endophytic; nearness; anterior/posterior; location) and preoperative aspects and dimensions used for anatomical classification (PADUA) nephrometry indices is used to predict complications related to surgical extirpation treatment for patients with clinical T1a/b renal mass. This single center study aims to investigate the value of these indices to predict complications in a cohort of patients treated with laparoscopic cryoablation (LCA) for cT1 renal mass. MATERIALS AND METHODS: Single institution data from consecutive LCA procedures were prospectively collected from December 2006 to April 2013. Renal mass anatomical complexity was categorized according to RENAL and PADUA indices. Comorbidity was assessed by the Charlson-index. Intraoperative complications (IOCs) were reviewed and categorized: blood loss >100 mL, conversion, tumor fracture, and incomplete ablation. Postoperative complications (POCs) were graded using the modified Clavien-index. Univariate and multivariate logistic regression models addressed the risk for complications. RESULTS: Ninety-nine LCA procedures were included. The median RENAL-score was 7.0 (standard deviation [SD] 1.7), and the median PADUA-score was 8.0 (SD 1.6). IOC occurred in 19 procedures (19%). The risk for IOC was significantly correlated (p<0.05) with tumor diameter (mm), surface, volume, the RENAL domains "R-size," "N-nearness to collecting system," "RENAL scor...