Avaliação prática do score R.E.N.A.L. em 150 nefrectomias parciais laparoscópicas para tratamento de massas renais

• Autor(a) principal: Dubeux, Victor Teixeira
• Data de Publicação: 2022
• Outros Autores: [e-mail]
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/19733
• topic: Laparoscopy; Nephron sparring surgery; R.E.N.A.L. score; Laparoscopia; Cirurgia poupadora de néfrons; Escore R.E.N.A.L.; Rins – Cirurgia; Néfrons – Cirurgia; Nefrectomia; CIENCIAS DA SAUDE::MEDICINA::CIRURGIA

Nephrometric scores play an interesting role in nephron sparring surgery (NSS) planning. The aim of this study is to evaluate if R.E.N.A.L. score (RS) is capable to predict the occurrence of adverse events in laparoscopic NSS. We prospectively studied 150 laparoscopic NSS between 2015 and 2018 to evaluate the relationship between RS and incidence of adverse events. Clavien 3 or superior complications, warm ischemia time (WIT) over 30 minutes, tumor violation, positive surgical margins (PSM) and necessity of amplification of renal parenchyma during the resection of the masses to obtain free margins were considered as adverse events. We compared each item of the RS isolated and divided the patients between low risk and high risk. Adverse results occurred in 48 cases (32%). Amplification of the margin of resection was observed in 28 cases (19%). WIT exceeded 30 minutes in 9 cases (6.1%), complications Clavien 3 or superior occurred in 13 cases (9%) and PSM were detected in 6 cases (4%). Comparing the patients with adverse outcomes and each item of the RS we did not find any statistical difference, but when divided into high risk and low risk, we found that patients in the high-risk group had a higher tendency to present ad-verse results - 25.84% vs. 44.26% (p=0.03). Concluded RS system is a good way to predict adverse outcomes in NSS, especially in cases over 7. Further studies should focus on robotic approach and patient’s characteristics other than the masses’ aspects.