Clinical Value Of R.E.N.A.L、DAP And PADUA Renal Tumor Scoring System For The Laparoscopic Partial Nephrectomy

Objective To explore whether there is a difference between the clinical application of R.E.N.A.L,DAP and PADUA renal tumor scoring system in laparoscopic nephron sparing surgery.Methods A total of 104 cases of patient with renal carcinoma who was admitted to the urinary surgery dept of our hospital and performed with a concurrent laparoscopic nephron-sparing surgery from Jan,2014 to Jun,2017 were collected,and they were included into this retrospective clinical research according to the same exclusion and inclusion standard,the single factor ANOVA,Kruskal-Wallis rank sum test were used to analyze the relationship between R.E.N.A.L,DAP,PADUA renal tumor scoring system and perioperative clinical indexes,and the correlation between the indexes of three scoring items and the clinical indexes of patients’ warm ischemia time,estimated bleeding amount,operation time and other clinical indexes was analyzed by using Spearman correlation analysis.The indexes of scoring items with strong correlation were screened out.Results In the R.E.N.A.L score,the estimated blood loss(EBL)amount of the high score group was more than that of the low score group(p=0.008),the high score group’s EBL was more than that of the low score(p=0.046)and the middle Score Group(p=0.043)in the DAP score(WIT),and the warm ischemia time(WIT)of the low score group was shorter than that of the middle(p=0.007)and high score group(p=0.009);In terms of PADUA score,the EBL in the high score group was more than that of the low score group(p=0.015);Spearman correlation analysis result showed that the maximum diameter of tumor was significantly statistically different from the EBL-related coefficient(ρ= 0.268,p<0.05)and the WIT(ρ=0.268,p<0.05)in terms of R.E.N.A.L score;The relationship between tumor and collecting system or the relationship between the renal sinus and EBL(ρ=0.238,p<0.05),the relationship between tumor and renal pole line and operation time(ρ=0.210,p<0.05);In terms of DAP score,the maximum diameter of the tumor on the cross section and the operation time(ρ=0.141,p<0.05),and the EBL(ρ=0.215,p<0.05);In terms of PADUA score,the relationship between the tumor and the renal sinus and operation time(ρ=0.196,p<0.05),the relationship between the tumor and collecting system and the EBL(ρ=0.220,p<0.05),the maximum diameter of the tumor and the EBL(ρ=0.214,p<0.05);Conclusion 1.The DAP renal tumor scoring system was superior to R.E.N.A.L.and PADUA scoring system in predicting surgical risk and postoperative complications;2.Among the three scoring systems,the relationship between tumor diameter,tumor and renal sinus or collecting system is more instructive in predicting the complexity of surgery.