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用于儿童脏节约手术的脏测量评分系统
Chaima Mrad1,2, Alexandre Chamouni1, Xavier Guerra3
1Department of Visceral and Neonatal Pediatric Surgery, Sorbonne University.
Journal of pediatric hematology/oncology
|November 14, 2023
概括
儿科脏瘤的脏节约手术 (NSS) 是一个复杂的过程. 像RENAL,PADUA和RTII这样的神经测量工具准确地分类了瘤的复杂性,可能会增加NSS的指示.
科学领域:
- 儿科泌尿外科 儿科泌尿外科
- 手术瘤学手术瘤学
- 医学成像分析 医学成像分析
背景情况:
- 脏节约手术 (NSS) 首选用于儿科脏瘤,但决策可能具有挑战性.
- 对于成年人瘤而言,已经建立了神经计分系统,但它们在儿童中的有用性不太明确.
- 准确的瘤复杂性评估对于选择适当的手术管理至关重要.
研究的目的:
- 追溯评估成人脏计分系统 (RENAL,PADUA,RTII) 在分类儿科瘤中的适用性和准确性.
- 为了将这些分数与手术结果相关联,特别是NSS与激进切除术的决定.
- 在儿科外科医生和放射科医生中评估这些评分系统的观察者间可靠性.
主要方法:
- 对2015-2019年期间治疗的44种儿科瘤的手术前成像的回顾性分析.
- 两个独立的外科医生和一名放射科医生应用RENAL,PADUA和RTII评分系统.
- 瘤复杂性得分与外科手术方法的相关性 (NSS,急性切除术,新辅助化疗随后进行手术).
主要成果:
- 在16例患者中进行了脏节约手术 (NSS),瘤在所有评估系统 (RENAL,PADUA,RTII) 中的复杂性得分明显较低.
- 低和中等风险类别的50%以上的患者接受了NSS,而高复杂性类别的约15%的患者也接受了NSS.
- 对于三个评分系统,观察者间可靠性很好,这表明它们的应用一致.
结论:
- 通过RENAL,PADUA和RTII评分系统,可以准确地分类儿科瘤的复杂性.
- 这些 nefrometric 工具在帮助手术决策方面表现有前途,可能会扩大儿童脏节约手术的指示.
- 这些分数的标准化应用可能会改善儿科脏瘤管理中的一致性和结果.
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