Correlation Analysis Between R.E.N.A.L. Nephrometry Score And T1 Stage Kidney Cancer Surgical Evaluation

Objective:To explore the clinical significance of R.E.N.A.L.nephrometry score in the selection of surgical methods for patients with T1 stage kidney cancer and analysis the correlation between factors such as the operative time,the warm ischemia time and the scoring system in laparoscopic partial nepphrectomy.Materials and methods:A retrospective analysis of clinical data of 223 patients with T1 stage kidney cancer were completed from June 2017 to June 2019.All patients including 134 males and 89 females were operated by the same operator;115 patients underwent laparoscopic radical nephrectomy and 108 patients underwent laparoscopic partial nepphrectomy.The data included general clinical data,imaging findings,perioperative situation and postoperative complications.According to the imaging data(CT,MRI,etc.),the R.E.N.A.L.scoring system will be used to evaluate the anatomic characteristics of renal tumors and the patients were divided into low complexity group,medium complexity group and high complexity group.At the same time,statistical methods were used to compare the relationship between different scoring levels and surgical procedure and to compare differences in perioperative parameters between different scoring levels and operation time,intraoperative thermal ischemia time,intraoperative bleeding volume,serum creatinine change range and perioperative complications in laparoscopic partial nepphrectomy.Result:It was found that R.E.N.A.L.nephrometry score was significantly correlated with the surgical procedures(P<0.001).The higher of R.E.N.A.L.nephrometry score,the more likely it is to choose radical nephrectomy.While the lower of R.E.N.A.L.nephrometry score,it is more likely to choose nephron sparing surgery.Radical nephrectomy is recommended when R.E.N.A.L.nephrometry score is greater than or equal to 9.The operation time(P < 0.001),the intraoperative warm ischemia time(P < 0.001)show significant positive correlation,but not with other factors such as intraoperative hemorrhage(P = 0.283),change rate of serum creatinine(P=0.379)and perioperative complications(P=0.419)in laparoscopic partial nepphrectomy.Conclusion:The R.E.N.A.L.nephrometry score can objectively and comprehensively describe the anatomical characteristics of tumors,which has important significance for the selection of surgical methods in patients with T1 stage kidney cancer.It can be seen that in laparoscopic partial nepphrectomy it has a positive correlation with operation time,intraoperative warm ischemia time,which has a certain predictive effect on the whole operation,but it still needs further study and evaluation of its value in predicting operation related outcome.