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Practical evaluation of the R.E.N.A.L. score system in 150 laparoscopic nephron sparing surgeries
Victor T Dubeux1, José Fernando C Zanier1, Pedro N Gabrich1
1Departamento de Urologia, Universidade do Estado do Rio de Janeiro - UERJ, Rio de Janeiro, RJ, Brasil.
Summary
The R.E.N.A.L. score (RS) can predict adverse outcomes in nephron sparing surgery (NSS). High-risk patients identified by RS have a greater likelihood of experiencing complications during laparoscopic NSS.
Area of Science:
- Urology
- Surgical Oncology
- Nephrology
Background:
- Nephron sparing surgery (NSS) planning relies on nephrometric scores.
- The R.E.N.A.L. score (RS) is a key metric in NSS.
Purpose of the Study:
- To evaluate the predictive capability of the R.E.N.A.L. score (RS) for adverse events in laparoscopic NSS.
- To assess the relationship between RS components and surgical outcomes.
Main Methods:
- A prospective study of 150 laparoscopic NSS procedures from 2015-2018.
- Adverse events included Clavien 3+ complications, warm ischemia time >30 min, tumor violation, positive surgical margins, and parenchymal amplification.
- Patients were stratified into low-risk and high-risk groups based on RS.
Main Results:
- 32% of patients experienced adverse outcomes.
- High-risk RS group showed a significantly higher incidence of adverse events (44.26%) compared to the low-risk group (25.84%, p=0.03).
- No significant difference was found when analyzing individual RS components.
Conclusions:
- The R.E.N.A.L. score effectively predicts adverse outcomes in NSS, particularly for scores exceeding 7.
- Future research should explore robotic approaches and patient-specific factors beyond tumor characteristics.
