Evaluation Of The Modified R.E.N.A.L. Nephrometry Score In Retroperitoneal Laparoscopic Partial Nephrectomy For T1Renal Cell Carcinoma

Objective: To evaluate the application value of modified R.E.N.A.L. nephrometry score in retroperitoneallaparoscopic partial nephrectomy for T1renal cell carcinoma.Methods: A retrospective analysis was conducted of clinical data of39patients with T1renal cellcarcinoma undergoing retroperitoneal laparoscopic partial nephrectomy by the same set of the surgeon andassistant who were admitted to the Department of Urology First affiliated hospital of Medical CollegeShihezi University from january.2007to June.2012. According to the operation time or warm ischemiatime divided the The difficulty of the operation into three levels, and then using the modifiedR.E.N.A.L.nephrometry score and R.E.N.A.L.nephrometry score to divided the The difficulty of theoperation into three levels, at last analysis the relationship of modified R.E.N.A.L. nephrometry score withperioperative outcomes and compare two scoring system to evaluate operation difficulty degree ofsensitivity specificity and Youden’s index.Results: A total of39patients（17males and22females）, mean age [54.3±12.0] years mean BMI [25.8±3.8kg/m2] mean radius[3.7±1.5cm] mean nearness of the tumor to the collecting system or sinus [5.7±2.3mm] mean ischemia time [18.6±5.7min] mean operation time [100.0±21.1min] mean blood loss[100.0±21.1min] mean hospitalization days [6.4±1.2d] fit for the stduy were collected. In2cases ofpreoperative patients with mild hypertension diabetes, research objects are no severe basic diseases,preoperative and postoperative creatinine values are normal, one case of patients with postoperative woundleak urine, and reinforcement of ureteral catheter drainage of detaining urethral catheter one week aftersymptoms disappear, no other serious complications, the difficulty of operation are17cases of low17cases of moderate and5cases of height. The results of R.E.N.A.L.score system are24cases operationdifficulty for low-grade，13cases of moderate and2cases of height， The results of the modifiedR.E.N.A.L.score system are15cases operation difficulty for low-grade，17cases of moderate and5casesof height，The modified R.E.N.A.L.nephrometry score are significantly associated with warm ischemiatime, surgery time and blood loss and were compared.the warm ischemia time, operation time and bloodloss（P<0.05），The modified R.E.N.A.L.nephrometry score to evaluate operation difficulty degree ofsensitivity specificity and Youden’s index are better.Conclusions: The modified R.E.N.A.L. nephrometry score more accurately reflects the characteristics ofT1renal cell carcinoma undergoing retroperitoneal laparoscopic partial nephrectomy, and can be used aspreoperative in patients with retroperitoneal laparoscopic partial nephrectomy in T1renal cell carcinomafor operation difficulty grading standards, But need to do the further prospective study.