演題抄録

ポスター

開催概要
開催回
第56回・2018年・横浜
 

ロボット支援下腎部分切除術におけるR.E.N.A.L. nephrometry scoreと術後成績の検討

演題番号 : P33-3

[筆頭演者]
演者)西川 涼馬:1 
[共同演者]
山根 浩史:1、西川 結梨:1、寺岡 祥吾:1、木村 有佑:1、弓岡 徹也:1、川本 文弥:1、岩本 秀人:1、森實 修一:1、引田 克弥:1、本田 正史:1、武中 篤:1

1:鳥取大学・腎泌尿器科

 

INTRODUCTION AND OBJECTS: The R.E.N.A.L. nephrometry scores (RNS) has been used in robotic-assisted partial nephrectomy (RAPN) and is considered to be effective. The aim of this study was to test the accuracy of RNS in evaluating perioperative outcomes of RAPN performed in our hospital.
MATERIALS AND METHODS: RNS was evaluated in 95 patients who underwent RAPN in our hospital from August 2011 to January 2018. Of the 5 components, 4 (Radius, Exophytic/endophytic properties, Nearness of the tumor to the collecting system or sinus, Location relative to polar lines) were scored on 1, 2, or 3-point scale. Renal tumors were categorized by RNS complexity as low (n=39. RNS sum, 4-6), moderate (n=45. sum, 7-9) and high (n=11. sum, 10-12). The relationships between the patients' scores and the outcomes of RAPN, warm ischemia time (WIT), tumor resection time, renorrhaphy time, postoperative complications, estimated blood loss (EBL), and percent change in estimated glomerular filtration rate (eGFR) were analyzed respectively. Trifecta was defined as achievement of negative surgical margin, no postoperative complications and WIT of <25 minutes.
RESULTS: Significant differences were seen in RNS low, moderate and high in WIT (19.2min vs. 21.1min vs. 22.4min: p=0.026), tumor resection time (7min vs. 9min vs. 11min: p=0.05), renorrhaphy time (11min vs. 14min vs. 12min: p=0.016), but EBT had no statistically significant result. Significant differences of decreasing rate in eGFR were seen in 1 week post-surgery (3.5% vs. 14.0% vs. 15.7%: p<0.001) and 1 month post-surgery (6.2% vs. 13.4% vs. 18.9%: p=0.001). The rate of achievement of Trifecta were 84.6% vs. 68.9% vs. 45.5% respectively (p=0.027).
CONCLUSIONS: The RNS are useful for predicting the complexity of RAPN. Also was associated with not only WIT, tumor resection time, renorrhaphy time and postoperative eGFR, but also achievement of Trifecta.

キーワード

臓器別:腎・尿路・膀胱

手法別:内視鏡手術

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