术前解剖特征分类评分系统在后腹腔镜肾部分切除术中的应用

Significance of the PADUA nephrometry score system for retroperitoneal laparoscopic partial nephrectomy

目的探讨术前解剖特征分类(PADUA)评分系统在后腹腔镜下肾部分切除术(RLPN)中的临床应用价值。方法回顾性分析2011年1月至2015年12月在徐州医科大学附属淮安医院及苏州大学附属第二医院收治的行RLPN的118例患者的临床资料,并应用PADUA评分系统对肿瘤进行评分,分析PADUA评分与手术时间、术中热缺血时间、术中出血量、术后住院时间、术后血肌酐变化、术后并发症等围手术期结局的相关性。结果 118例患者中,其中低度复杂组40例,中度复杂组58例,高度复杂组20例。相关分析显示:各组与手术时间(P=0.017)、术中热缺血时间(P=0.034)、术中出血量(P=0.002)及术后并发症(P=0.023)均显著相关,而与术后住院时间(P=0.857)、术后血肌酐变化(P=0.567)等无明显相关关系。结论 PADUA评分系统较全面评价肾脏肿瘤解剖特点,对RLPN的风险及手术难度有一定预测作用,但仍然需进一步研究其临床应用价值。

Objective To evaluate the efficacy of the PADUA nephrometry score system for retroperitoneal laparoscopic partial nephrectomy(RLPN). Methods Clinical data of 118 patients who were treated with RLPN in Huai’an Hospital Affiliated of Xuzhou Medical University and the Second Affiliated Hospital of Soochow University from January 2011 to December 2015 were retrospectively analyzed. The correlation between perioperative such as operation time, warm ischemia time, blood loss, postoperative hospital stay, serum creatinine level as well as postoperative complications and PADUA nephrometry score system were analyzed. Results Among the 118 cases, 40, 58, 20 were rated as low, moderate and high in complications. Studied by the PADUA nephrometry score system, there were significant between patients of different PADUA nephrometry score system categories in operation time(P=0.017), warm ischemia time(P=0.034), blood loss(P=0.002) and postoperative complications(P=0.023). There were no difference in postoperative hospital stay(P=0.857) and serum creatinine level(P=0.567). Conclusions The PADUA nephrometry score system is a useful tool which can delineate anatomy characteristics of renal tumors comprehensively. PADUA nephrometry score system could estimate surgical outcomes of RLPN. However, further research is required to evaluate its clinical significance more accurately.