<scp>PADUA</scp> and R.E.N.A.L. nephrometry scores correlate with perioperative outcomes of robot‐assisted partial nephrectomy: analysis of the Vattikuti Global Quality Initiative in Robotic Urologic Surgery (<scp>GQI</scp>‐<scp>RUS</scp>) database

Schiavina, Riccardo; Novara, Giacomo; Borghesi, Marco; Ficarra, Vincenzo; Ahlawat, Rajesh; Moon, Daniel; Porpiglia, Francesco; Challacombe, Benjamin; Dasgupta, Prokar; Brunocilla, Eugenio; Manna, Gaetano La; Volpe, Alessandro; Verma, Hema; Martorana, Giuseppe; Mottrie, Alexandre

doi:10.1111/bju.13628

Cited by 84 publications

(62 citation statements)

References 32 publications

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“…Over the past decade, in the minimally invasive PN setting , nephrometry scores have been widely implemented in clinical practice ; however, results of validation studies on the predictive role of these tools are still conflicting , and the debate about which of the nephrometry scores more precisely correlates with peri‐operative outcomes is ongoing. It is also notable that all current nephrometry scores are calculated based on bi‐dimensional imaging .…”

Section: Discussionmentioning

confidence: 99%

Three‐dimensional virtual imaging of renal tumours: a new tool to improve the accuracy of nephrometry scores

et al. 2019

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ObjectivesTo apply the standard PADUA and RENAL nephrometry score variables to three-dimensional (3D) virtual models (VMs) produced from standard bi-dimensional imaging, thereby creating three-dimensional (3D)-based (PADUA and RENAL) nephrometry scores/categories for the reclassification of the surgical complexity of renal masses, and to compare the new 3D nephrometry score/category with the standard 2D-based nephrometry score/category, in order to evaluate their predictive role for postoperative complications. Materials and MethodsAll patients with localized renal tumours scheduled for minimally invasive partial nephrectomy (PN) between September 2016 and September 2018 underwent 3D and 2D nephrometry score/category assessments preoperatively. After nephrometry score/category evaluation, all the patients underwent surgery. Chi-squared tests were used to evaluate the individual patients' grouping on the basis of the imaging tool (3D VMs and 2D imaging) used to assess the nephrometry score/category, while Cohen's j coefficient was used to test the concordance between classifications. Receiver-operating characteristic curves were produced to evaluate the sensitivity and specificity of the 3D nephrometry score/category vs the 2D nephrometry score/ category in predicting the occurrence of postoperative complications. A general linear model was used to perform multivariable analyses to identify predictors of overall and major postoperative complications. ConclusionsIn the present study, we showed that 3D VMs were more precise than 2D standard imaging in evaluating the surgical complexity of renal masses according to nephrometry score/ category. This was attributable to a better perception of tumour depth and its relationships with intrarenal structures using the 3D VM, as confirmed by the higher accuracy of the 3D VM in predicting postoperative complications.Additional Supporting Information may be found in the online version of this article: Table S1. Multivariable analysis identifying the preoperative independent predictors of overall complication and major complications for PADUA and RENAL score. 954

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Section: Discussionmentioning

confidence: 99%

Three‐dimensional virtual imaging of renal tumours: a new tool to improve the accuracy of nephrometry scores

et al. 2019

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“…Theoretically, neoadjuvant chemotherapy could further expand the number of patients eligible for PN; however, this would represent a major shift in current treatment strategies for Wilms’ tumor in North America. In the case of pediatric RCC, the successful oncologic and renal function outcomes in the adult population strongly support PN for amenable renal masses regardless of age [14]. This emerging niche for partial nephrectomy presents an opportunity for pediatric urologists to usher in a robotic approach.…”

Section: Discussionmentioning

confidence: 99%

Collaborating with our adult colleagues: A case series of robotic surgery for suspicious and cancerous lesions in children and young adults performed in a free-standing children's hospital

Varda

Cho

Wagner

et al. 2018

Journal of Pediatric Urology

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Summary Background In adult urologic oncology the use of robotics has become commonplace; in pediatric urology it is rare. Herein, we describe a collaboration between an adult and a pediatric urologist performing robotic surgery for children and young adults with suspicious or cancerous genitourinary (GU) lesions. Objectives To evaluate clinical and oncologic outcomes in children and young adults undergoing robotic surgery for suspicious or cancerous lesions of the GU tract; to describe our collaborative model between an adult and pediatric surgeon at a free-standing children’s hospital. Design We retrospectively reviewed all robotic cases performed at our institution from 2014 to 2016 for patients with a GU malignancy or a suspicious mass. The surgeries were performed by a pediatric urologist with robotic experience and a fellowship-trained MIS adult urologist specializing in oncology. Perioperative and oncologic outcomes were recorded. Results A total of eight robotic cases were performed: four partial nephrectomies (PN) with retroperitoneal lymph node dissection (LND) (OT 269–338 min, EBL 5–300 mL, LOS 3–6 days), one adrenalectomy with LND (6.4 cm mass; OT 172 min, EBL 5 mL, LOS 3 days), one nephrectomy with pericaval LND (9.8 cm mass; 234 min, EBL 25 mL, LOS 3 days), and two retroperitoneal LNDs (OT 572 and 508 min, EBL 250 and 100, LOS 3 and 4 days). Patient weights ranged from 14 to 79 kg (mean 53.4 kg). There were no major complications (Clavien 3–5). Pathology results for PN included papillary RCC (AJCC pT1aNx) and two cases of segmental cystic renal dysplasia with nephrogenic rests. Bilateral template RPLNDs yielded paratesticular rhabdomyosarcoma (43 nodes; COG low risk group II stage I) and mixed non-seminomatous germ cell tumor (74 nodes; COG stage III). The nephrectomy yielded an undifferentiated sarcoma, low grade; the adrenalectomy favorable-type ganglioneuroma. Discussion In pediatrics, urologic oncology cases are often managed with open surgery. Our series demonstrates the feasibility of using the robotic approach in carefully selected cases. In doing so, the patient benefits from a minimally invasive surgery, while the surgeon benefits from robotic surgical dexterity. We seamlessly advanced these new techniques through a step-wise collaboration between an adult urologist who routinely performs robotic oncology procedures and a pediatric urologist experienced in robotics for benign conditions. Conclusion In this small series, we safely and effectively adapted adult robotic techniques for genitourinary oncology cases in children and young adults.

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“…Preoperative knowledge of the complexity of a renal mass is the cornerstone for planning a partial nephrectomy (PN) [1]. Given the multiple variables characterizing it – size, length of protrusion from renal parenchyma, longitudinal and coronal location, proximity to the hilum – several nephrometric scoring systems have been proposed during the last decade [2,3]; the RENAL and PADUA classifications are the most widely used of these [4‐6]. Such systems are based, however, on conventional two‐dimensional (2D) imaging rendered as greyscale, which requires a type of cognitive three‐dimensional (3D) reconstruction of a complex structure such as the kidney.…”

Section: Figmentioning

confidence: 99%

Three‐dimensional virtual reconstruction with DocDo, a novel interactive tool to score renal mass complexity

Rocco

Sighinolfi

Menezes³

et al. 2020

BJU International

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PADUA and R.E.N.A.L. nephrometry scores correlate with perioperative outcomes of robot‐assisted partial nephrectomy: analysis of the Vattikuti Global Quality Initiative in Robotic Urologic Surgery (GQI‐RUS) database

Cited by 84 publications

References 32 publications

Three‐dimensional virtual imaging of renal tumours: a new tool to improve the accuracy of nephrometry scores

Three‐dimensional virtual imaging of renal tumours: a new tool to improve the accuracy of nephrometry scores

Collaborating with our adult colleagues: A case series of robotic surgery for suspicious and cancerous lesions in children and young adults performed in a free-standing children's hospital

Three‐dimensional virtual reconstruction with DocDo, a novel interactive tool to score renal mass complexity

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