Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
BJU Int. 2013 Dec;112(8):1121-4. doi: 10.1111/bju.12276.
To assess whether the R.E.N.A.L. nephrometry score (consists of [R]adius [tumour size as maximal diameter], [E]xophytic/endophytic properties of the tumour, [N]earness of tumour deepest portion to the collecting system or sinus, [A]nterior [a]/posterior [p] descriptor and the [L]ocation relative to the polar line) is associated with complication risk in patients that have radiofrequency ablation (RFA) for small renal masses (SRMs). To evaluate a standardised system for predicting complication risks which has not been studied.
We reviewed the records of all patients who underwent RFA at our institution between May 2001 and May 2011. RFA was performed using a temperature-based system and a 25-G nine-tine array needle probe. Patients with preoperative imaging available for R.E.N.A.L. nephrometry scoring were included. R.E.N.A.L. composite scores, tertile stratification and preoperative patient characteristics were analysed for significance in relation to complications. Complications were defined using the Clavien-Dindo classification system.
In all, 199 patients had preoperative R.E.N.A.L. nephrometry scores available; 170 underwent percutaneous RFA and 29 laparoscopic RFA. The mean (range) American Society of Anesthesiologists (ASA) score was 2.6 (1-4). The mean (range) tumour size was 2.4 (0.7-5.4) cm. Overall, 14 complications were identified; 10 minor (Clavien I-II) and four major (Clavien III-IV). There was no significant association between complications and R.E.N.A.L. nephrometry score, R.E.N.A.L. nephrometry tertiles, tumour diameter, tumour location or ASA score (P > 0.05).
R.E.N.A.L. nephrometry scoring fails to predict complications of RFA for SRMs when using a temperature-based nine-tine array probe.
评估 R.E.N.A.L. 肾脏肿瘤解剖评分（由[肿瘤最大直径的]半径 [肿瘤的外生性/内生性特征]、[肿瘤最深部位与集合系统或窦腔的]邻近度、[A] 前/[p] 后描述符和[L] 相对于极线的位置）与接受射频消融 (RFA) 治疗小肾肿瘤 (SRM) 的患者的并发症风险之间的关系。评估尚未研究过的预测并发症风险的标准化系统。
我们回顾了 2001 年 5 月至 2011 年 5 月期间在我们机构接受 RFA 的所有患者的记录。RFA 使用基于温度的系统和 25-G 九针阵列探针进行。包括术前有 R.E.N.A.L. 肾脏肿瘤解剖评分可用的影像学检查的患者。分析 R.E.N.A.L. 综合评分、三分位分层和术前患者特征与并发症的关系。并发症使用 Clavien-Dindo 分类系统定义。
共有 199 例患者术前有 R.E.N.A.L. 肾脏肿瘤解剖评分；170 例接受经皮 RFA，29 例接受腹腔镜 RFA。美国麻醉医师协会 (ASA) 评分的平均值（范围）为 2.6（1-4）。肿瘤大小的平均值（范围）为 2.4（0.7-5.4）cm。共有 14 例并发症，10 例为轻度（Clavien I-II），4 例为重度（Clavien III-IV）。并发症与 R.E.N.A.L. 肾脏肿瘤解剖评分、R.E.N.A.L. 肾脏肿瘤解剖评分三分位、肿瘤直径、肿瘤位置或 ASA 评分之间无显著相关性（P > 0.05）。
当使用基于温度的九针阵列探针时，R.E.N.A.L. 肾脏肿瘤解剖评分无法预测 SRM 的 RFA 并发症。
