The Harbin Medical University nephrectomy score: a quantitative system for evaluating the complexity of laparoscopic retroperitoneal simple nephrectomy

Liu, Yiwen; Wang, Chunyang; Wu, Xiuhai; Kong, Linglong; Ni, Shaobin

doi:10.1590/s1677-5538.ibju.2018.0634

Cited by 2 publications

(2 citation statements)

References 31 publications

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“…The inflammation of the perinephric and perihilar area is the main concern when performing SN [11]. There are often dense adhesions between the inflamed kidney and overlying bowel in patients with previous pyonephrosis and calculus pyelonephritis.…”

Section: Discussionmentioning

confidence: 99%

The Simple Nephrectomy Is Not Always Simple: Predictors of Surgical Difficulties

et al. 2022

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Background: Inflammation is one of the major risk factors for SN complications because the dense and fibrotic tissue leads to significant challenges to dissection. Objectives: We aimed to evaluate the predictive factors preoperatively, especially inflammation markers and radiologic findings, which can pose challenges to surgery in simple nephrectomy. Methods: We retrospectively evaluated the data of 156 patients who underwent simple open nephrectomy. There were 87 patients in group 1 (peroperative nonadherent perinephric fat) and 69 patients in group 2 (peroperative adherent perinephric fat). The preoperative computed tomography findings (renal volume, perinephric stranding, posterior perinephric fat thickness, lateral perinephric fat thickness, Hounsfield unit [HU] of perinephric fat, HU of subcutaneous fat, HU of renal parenchyma, HU of renal pelvis), side of the kidney affected, prior surgery at the same kidney, complication rates, and operative time were analyzed. Preoperative inflammation markers, neutrophil-lymphocyte ratio, systemic immune-inflammation index, monocyte-HDL ratio, and platelet-lymphocyte ratio levels were recorded. Results: Preoperative NLR and SII were statistically higher, and HDL was statistically lower in group 2; there was no difference in PLR and monocyte-HDL ratio between the 2 groups. According to the preoperative imaging, the perinephric stranding, HU of perinephric fat, and HU of renal parenchyma were higher in group 2, 54 (78.3), −36.93 (−91.46, −21.69), and 38.60 (32.11, 41.94), respectively. DM, history of nonsterile urine culture, HU of perinephric fat >61.78, and SII >689.36 were the factors that could be identified as independent significant predictors of presence of adherent perinephric fat. Conclusion: The radiological findings and inflammation markers can be used as the predictive factor for peroperative adherent perinephric tissue and surgical difficulties.

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Section: Discussionmentioning

confidence: 99%

The Simple Nephrectomy Is Not Always Simple: Predictors of Surgical Difficulties

et al. 2022

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“…Numerous factors are involved in surgical conversion, including the surgeon's experience, renal characteristics, and even team cooperation [ 8 ]. In this regard, an increasing number of clinical parameters and tumor-related features are further included to improve the predictive ability of different models [ 15 ]. However, regardless of their improved predictive accuracy, these new models may be too complex for clinical practice, and some of their components may be less important, which can in turn diminish their actual predictive power [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Development of a simple nomogram to estimate risk for intraoperative complications before partial nephrectomy based on the Mayo Adhesive Probability score combined with the RENAL nephrometry score

Tan

Jin

et al. 2021

Investig Clin Urol

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Purpose This study aimed to develop a simple nomogram based on the Mayo Adhesive Probability (MAP) score combined with the RENAL nephrometry score (RNS) to predict intraoperative complications before partial nephrectomy (PN) in Asian populations. Materials and Methods This study retrospectively collected patients undergoing PN at three medical centers. Each component of the MAP score and the RNS (6 variables) was evaluated to assess its association with intraoperative complications by multivariable logistic regression with backward elimination. Results A total of 46 cases (7.2%) with intraoperative complications were identified among 637 patients. After backward elimination, three variables, including tumor diameter (4–7 cm vs. ≤4 cm: odds ratio [OR], 4.339; 95% confidence interval [CI], 1.943–9,692; ≥7 cm vs. ≤4 cm: OR, 8.434; 95% CI, 1.225–58.090), nearness to the collecting system (4–7 mm vs. ≥7 mm: OR, 2.988; 95% CI, 1.293–6.907; ≤4 mm vs. ≥7 mm: OR, 21.394; 95% CI, 6.122–74.756), and perirenal fat stranding type (type 1 vs. no stranding: OR, 3.119; 95% CI, 1.079–9.017; type 2 vs. no stranding: OR, 18.722; 95% CI, 6.757–51.868), were retained. The predictive power (measured by area under the curve [AUC]) of the nomogram was observed to be superior to the RNS or MAP score alone (RNS: 0.686, MAP score: 0.729, the nomogram: 0.837), but comparable to their combination (0.813). Conclusions The simple nomogram contains fewer components than the combination of the RNS and MAP scores yet demonstrates equivalent predictive power for intraoperative complications.

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The Harbin Medical University nephrectomy score: a quantitative system for evaluating the complexity of laparoscopic retroperitoneal simple nephrectomy

Cited by 2 publications

References 31 publications

The Simple Nephrectomy Is Not Always Simple: Predictors of Surgical Difficulties

The Simple Nephrectomy Is Not Always Simple: Predictors of Surgical Difficulties

Development of a simple nomogram to estimate risk for intraoperative complications before partial nephrectomy based on the Mayo Adhesive Probability score combined with the RENAL nephrometry score

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