Kasap Yusuf, Senel Samet, Tastemur Sedat, Olcucuoglu Erkan
Department of Urology, Ankara City Hospital, Üniversiteler Mahallesi, 1604. Cadde No: 9 Çankaya, Ankara, Turkey.
Int Urol Nephrol. 2022 Sep;54(9):2149-2156. doi: 10.1007/s11255-022-03269-3. Epub 2022 Jun 29.
To evaluate the usefulness of E-PASS score to predict postoperative complications after laparoscopic nephrectomy.
Between 2008 and 2020, 424 patients (179 patients: simple nephrectomy, 158 patients: radical nephrectomy, 87 patients: donor nephrectomy) who underwent laparoscopic nephrectomy in our clinic, were included in the study. Patient groups separated according to the presence of postoperative complications were compared retrospectively regarding demographic, clinical, intraoperative, and postoperative data, comorbidities, and E-PASS scores (PRS, SSS, and CRS). The relationship between postoperative complications and E-PASS scores was examined.
Postoperative complications occurred in 43 (10.1%) of the patients. Age, previous abdominal/retroperitoneal surgery, radical nephrectomy rate of surgeries, operation time, amount of bleeding, need for blood transfusion, rate of conversion from laparoscopic surgery to open surgery, hospitalization time, E-PASS PRS, SSS, and CRS were statistically significantly higher in the group with postoperative complications. The cutoff value of the E-PASS CRS was - 0.2996 to predict the development of postoperative complications (AUC = 0.706; 95% CI 0.629-0.783; p < 0.001). According to multivariate analysis, presence of previous abdominal/retroperitoneal surgery (OR 2.977; 95% CI 1.502-5.899; p = 0.002), laparoscopic radical nephrectomy (OR 2.518; 95% CI 1.224-5.179; p = 0.012), conversion from laparoscopic surgery to open surgery (OR 4.869; 95% CI 1.046-22.669; p = 0.044) and E-PASS CRS > - 0.2996 (OR 2.816; 95% CI 1.321-6.004; p = 0.007) were found to be independent risk factors predicting postoperative complications.
The E-PASS scoring system is an effective and convenient system for predicting postoperative complications after laparoscopic nephrectomy.
评估E-PASS评分对预测腹腔镜肾切除术后并发症的有效性。
2008年至2020年间，我院424例行腹腔镜肾切除术的患者（179例：单纯肾切除术，158例：根治性肾切除术，87例：供体肾切除术）纳入本研究。根据术后并发症的有无将患者分组，对人口统计学、临床、术中及术后数据、合并症和E-PASS评分（PRS、SSS和CRS）进行回顾性比较。研究术后并发症与E-PASS评分之间的关系。
43例（10.1%）患者发生术后并发症。术后并发症组患者的年龄、既往腹部/腹膜后手术史、根治性肾切除术比例、手术时间、出血量、输血需求、腹腔镜手术转为开放手术的比例、住院时间、E-PASS PRS、SSS和CRS在统计学上显著更高。E-PASS CRS预测术后并发症发生的截断值为-0.2996（AUC = 0.706；95% CI 0.629 - 0.783；p < 0.001）。多因素分析显示，既往腹部/腹膜后手术史（OR 2.977；95% CI 1.502 - 5.899；p = 0.002）、腹腔镜根治性肾切除术（OR 2.518；95% CI 1.224 - 5.179；p = 0.012）、腹腔镜手术转为开放手术（OR 4.869；95% CI 1.046 - 22.669；p = 0.044）以及E-PASS CRS > -0.2996（OR 2.816；95% CI 1.321 - 6.004；p = 0.007）是预测术后并发症的独立危险因素。
E-PASS评分系统是预测腹腔镜肾切除术后并发症的有效且便捷的系统。
