The Research Of The Choose Value Of The R.E.N.A.L. Nephrometry Scor To Keep Nephron Sparing Surgery

Objective: To explore the value of the R.E.N.A.L. Nephrometry Scor in patients with renal tumor in choice of operation method of retain renal and to understand the significance of its clinical application.Method: retrospectively analyzed the clinical data of the patients with renal tumor who had the surgery of reserves the nephron sparing in Wannan medical college of yijishan hospital from September 2012 to October 2014. A total of 67 cases of eligible patients were included in the study, 39 cases of them were used the open renal resection surgery and 28 cases were used the laparoscopic renal resection surgery. All operations were completed by the same surgeon, Data includes general clinical data and preoperative imaging examination results, perioperative data and postoperative complications. Used the R.E.N.A.L. Nephrometry Scor to quantite score for all the anatomical characteristics of renal tumor patients on the basis of the results of the preoperative image data of the patients. Comparing the relationship between different grading complexity and the choice of operation method and the occurrence of postoperative complications by x2 test. Analyze the relationship between R.E.N.A.L. Nephrometry Scor and patients age, renal pedicle blocking time, operation time, intraoperative blood loss, Serum creatinine rate, postoperative length of hospital stay and the relationship between Serum creatinine and ratepostoperative length of hospital stay, to understand the influence of factors of each operation method choice under different gradingResults: Through the analysis of the relationship between R.E.N.A.L. Nephrometry Scor and patients age, renal pedicle blocking time, operation time, intraoperative blood loss, Serum creatinine rate, postoperative length of hospital stay, We found the significant correlations between R.E.N.A.L. system and laparoscopic partial nephrectomy surgery time(P=0.024),renal pedicle blocking time(P=0.021) and Intraoperative blood loss(P=0.006).There were no significant correlations between the R.E.N.A.L. system and open partial nephrectomy surgery time(P=0.584),renal pedicle block of time(P=0.472),intraoperative blood loss(P=0.193).There were no significant correlations between whether laparoscopic partial nephrectomy nor open partial nephrectomy and patients sex, age, serum creatinine rate and postoperative hospitalization days. There was a significant correlation between the total score of R.E.N.A.L. Nephrometry Scor and surgical methods,the higher the score or the more complex, the more inclined to choose the open partial nephrectomy.There was no correlation between the total score of R.E.N.A.L. Nephrometry Scor and the occurrence of postoperative complications. There were no statistical significances of the differences between them when grading in low-grade complex wether in thermal ischemia time, operation time nor intraoperative blood loss. But when marking in moderatly、highly complex,there was significancant difference in renal pedicle blocking time though there was no difference in operative time or intraoperative blood lossConclusion: R.E.N.A.L. scoring system can be used to describe the anatomical features of kidney tumors accurately,so there was of great significance in choice of method of renal resection operation.1.R.E.N.A.L. Nephrometry Scor is simple in measurement and operation,consistent in the score and good in repeatability.2.R.E.N.A.L. Nephrometry Scor can predict renal pedicle blocking time in pre-operation,contributing to avoid kidney damage because of intraoperative renal ischemia time is too long.3.R.E.N.A.L. total score affect the choice of the surgical procedure,It is suitable for OPN when the total score is high,It is suitable for the LPN when the total score is low.4.R.E.N.A.L Nephrometry Scor has no prediction effect for the occurrence of postoperative complications.