Journal of Shandong University (Health Sciences) ›› 2020, Vol. 58 ›› Issue (9): 52-57.doi: 10.6040/j.issn.1671-7554.0.2020.0703

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Application of CT three-dimensional reconstruction modified R.E.N.A.L. score in 50 cases of laparoscopic partial nephrectomy

GAO Pei1, MAO Changlin1, CHEN Feng1, HE Wei2, GUAN Yong2,LYU Jiaju1,2, LI Shanjun2, DING Sentai1,2   

  1. 1. Department of Urology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong, China;
    2. Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China
  • Online:2020-09-10 Published:2020-08-30

Abstract: Objective To explore the application value of the modified R.E.N.A.L.(radius, exophytic/endophytic, nearness, anterior/posterior, location)scoring system based on CT three-dimensional(3D)reconstruction technology in laparoscopic partial nephrectomy(LPN)for renal cell carcinoma(RCC). Methods A total of 50 patients undergoing LPN for stage T1 RCC in the Department of Urology of Shandong Provincial Hospital during Sep. 2018 and Nov. 2019 were enrolled. CT 3D reconstruction was performed in all patients before surgery, who were evaluated with the conventional R.E.N.A.L. score and modified R.E.N.A.L. score, respectively. The results were compared with the actual surgery. The correlation between the modified R.E.N.A.L. score and operation time, hospitalization days, intraoperative warm ischemia time(WIT), postoperative hemoglobin reduction, serum creatinine and blood urea nitrogen was analyzed with Spearman’s rank correlation analysis. Results There was a significant positive correlation between the modified R.E.N.A.L score and operation time, WIT, and hemoglobin reduction(rs=0.570, 0.802, 0.903, P<0.001). The specificity, sensitivity and Yoden index of the modified R.E.N.A.L. score were significantly better than those of the conventional R.E.N.A.L. score. Conclusion The CT 3D reconstruction modified R.E.N.A.L. scoring system is more accurate than conventional R.E.N.A.L. scoring system in evaluating the surgical difficulty, and it can predict the perioperative indicators.

Key words: CT three-dimensional reconstruction, R.E.N.A.L. score, CT three-dimensional reconstruction modified R.E.N.A.L. score, Tumor diameter ratio, Laparoscopic partial nephrectomy

CLC Number: 

  • R737.11
[1] Capitanio U, Bensalah K, Bex A, et al. Epidemiology of renal cell carcinoma [J]. Eur Urol, 2019, 75(1): 74-84.
[2] Yoon YE, Lee HH, Kim KH, et al. Focal therapy versus robot-assisted partial nephrectomy in the management of clinical T1 renal masses: a systematic review and meta-analysis [J]. Medicine, 2018, 97(45): e13102. doi:10.1097/MD.0000000000013102.
[3] Kutikov A, Uzzo RG. The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth [J]. J Urol, 2009, 182(3): 844-853.
[4] Sasaguri K, Takahashi N. CT and MR imaging for solid renal mass characterization [J]. Eur J Radiol, 2018, 99: 40-54. doi:10.1016/j.ejrad.2017.12.008.
[5] Glybochko PV, Alyaev YG, Khokhlachev SB, et al. 3D reconstruction of CT scans aid in preoperative planning for sarcomatoid renal cancer: A case report and mini-review [J]. J Xray Sci Technol, 2019, 27(2): 389-395.
[6] 窦瑞欣, 薛敏娜, 李国华. 基于VTK实现三维重建在胆囊管变异中的诊断价值[J]. 山东大学学报(医学版), 2017, 55(7): 84-88. DOU Ruixin, XUE Minna, LI Guohua. Diagnostic value of three-dimensional reconstruction in cystic duct variation based on VTK [J]. Journal of Shandong University(Health Sciences), 2017, 55(7): 84-88.
[7] Fujiki T, Nishimura R, Mase S, et al. Accurate detection of renal leukemic involvement in children using 3-D computed tomography modeling [J]. Pediatr Int, 2019, 61(7): 679-687.
[8] Elhadidi M, Aldahouk A, Shawky M, et al. Computer-guided calvarial mono-cortical bone blocks harvest: a novel approach for three-dimensional alveolar reconstruction of atrophic maxilla [J]. Clin Implant Dent Relat Res, 2019, 21(1): 85-93.
[9] Wang Z, Qi L, Yuan P, et al. Application of three-dimensional visualization technology in laparoscopic partial nephrectomy of renal tumor: A comparative study [J]. J Laparoendosc Adv Surg Tech A, 2017, 27(5): 516-523.
[10] Campbell S, Uzzo RG, Allaf ME, et al. Renal mass and localized renal cancer: AUA guideline [J]. J Urol, 2017, 198(3): 520-529.
[11] Chen SH, Wu YP, Li XD, et al. R.E.N.A.L. Nephrometry score: a preoperative risk factor predicting the Fuhrman grade of clear-cell renal carcinoma [J]. J Cancer, 2017, 8(18): 3725-3732.
[12] Li J, Zhang Y, Teng Z, et al. Partial nephrectomy versus radical nephrectomy for cT2 or greater renal tumors: a systematic review and meta-analysis [J]. Minerva Urol Nefrol, 2019,71(5): 435-444.
[13] Alkazemi MH, Dionise ZR, Jiang R, et al. Partial and radical nephrectomy in children, adolescents, and young adults: Equivalent readmissions and postoperative complications [J]. J Pediatr Surg, 2019, 54(11): 2343-2347.
[14] Chung DY, Lee JS, Ahmad A, et al. Lessons learned from clinical outcome and tumor features of patients underwent selective artery embolization due to postoperative bleeding following 2076 partial nephrectomies: propensity scoring matched study [J]. World J Urol, 2020, 38(5): 1235-1242.
[15] Antonelli A, Veccia A, Sandri M, et al. External validation of the arterial-based complexity score and first head-to-head comparison with the R.E.N.A.L. and PADUA scores and C-index [J]. Clin Genitourin Cancer, 2018, 16(3): e595-e604.
[16] Sterzik A, Solyanik O, Eichelberg C, et al. Improved prediction of nephron-sparing surgery versus radical nephrectomy by the optimized R.E.N.A.L. score in patients undergoing surgery for renal masses [J]. Minerva Urol Nefrol, 2019, 71(3): 249-257.
[17] Mouracade P, Kara O, Maurice MJ, et al. Patterns and predictors of recurrence after partial nephrectomy for kidney tumors [J]. J Urol, 2017, 197(6): 1403-1409.
[18] Dahlkamp L, Haeuser L, Winnekendonk G, et al. Interdisciplinary comparison of PADUA and R.E.N.A.L. scoring systems for prediction of conversion to nephrectomy in patients with renal mass scheduled for nephron sparing surgery [J]. J Urol, 2019, 202(5): 890-898.
[19] Zhou HJ, Yan Y, Zhang JZ, et al. Role of R.E.N.A.L. nephrometry score in laparoscopic partial nephrectomy [J]. Chin Med J(Engl), 2017, 130(18): 2170-2175.
[20] Manno C, Campobasso N, Nardecchia A, et al. Relationship of para- and perirenal fat and epicardial fat with metabolic parameters in overweight and obese subjects [J]. Eat Weight Disord, 2019, 24(1): 67-72.
[21] Capitanio U, Bensalah K, Bex A, et al. Epidemiology of renal cell carcinoma [J]. Eur Urol, 2019, 75(1): 74-84.
[22] Gray RE, Harris GT. Renal cell carcinoma: diagnosis and management [J]. Am Fam Physician, 2019, 99(3): 179-184.
[23] Kott O, Golijanin B, Pereira JF, et al. The BMI paradox and robotic assisted partial nephrectomy [J]. Front Surg, 2020, 6: 74-79. doi:10.3389/fsurg.2019.00074.
[24] Ricci MA, Scavizzi M, Ministrini S, et al. Morbid obesity and hypertension: the role of perirenal fat [J]. J Clin Hypertens(Greenwich), 2018, 20(10): 1430-1437.
[25] Favre G, Grangeon-Chapon C, Raffaelli C, et al. Perirenal fat thickness measured with computed tomography is a reliable estimate of perirenal fat mass [J]. PLoS One, 2017, 12(4): e0175561. doi:10.1371/journal.pone.0175561.
[26] Huang T, Chen Z, Shen L, et al. Associations of cognitive function with BMI, body fat mass and visceral fat in young adulthood [J]. Medicina(Kaunas), 2019, 55(6): 221. doi:10.3390/medicina55060221.
[27] Kobayashi Y, Kurahashi H, Matsumoto Y, et al. Factors predicting adhesion between renal capsule and perinephric adipose tissue in partial nephrectomy [J]. Acta Med Okayama, 2016, 70(2): 69-74.
[28] Lauder L, Ewen S, Tzafriri AR, et al. Renal artery anatomy assessed by quantitative analysis of selective renal angiography in 1,000 patients with hypertension [J]. Euro Intervention, 2018, 14(1): 121-128.
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