Department of Urology, Zhongshan Hospital, Fudan University, 180th Fengling Rd, Xuhui District, Shanghai, 200032, China.
Department of Urology, Xuhui Hospital, Fudan University, 966th Huaihai Middle Rd, Xuhui District, Shanghai, 200031, China.
World J Urol. 2024 Apr 2;42(1):208. doi: 10.1007/s00345-024-04891-9.
To determine the relationship between renal tumor complexity and vascular complications after partial nephrectomy using PADUA, RENAL, and ZS scores.
Between January 2007 and December 2018, a total of 1917 patients with available cross-sectional imaging were enrolled in the study. Logistic regressions were used to identify independent predictors of vascular complications.
Of 1917 patients, 31 (1.6%) developed vascular complications, including 10 females and 21 males. The high-complexity category was significantly associated with a decreased risk of vascular complication in PADUA (OR = 0.256; 95%CI = 0.086-0.762; P = 0.014) and ZS score (OR = 0.279; 95%CI = 0.083-0.946; P = 0.040). Laparoscopic partial nephrectomy and robot-assisted laparoscopic partial nephrectomy were independent risk factors for vascular complications. Meanwhile, the incidence was significantly reduced in the recent 4 years in the high score tumor group alone in PADUA (0.2% [1/474] vs. 2.2% [3/139], P = 0.038) and ZS score (0.2% [1/469] vs. 2.7% [3/112], P = 0.024). In the first 8 years, laparoscopic partial nephrectomy and robot-assisted laparoscopic partial nephrectomy were the only two independent risk factors for vascular complications. In the recent 4 years, only the high-complexity category was significantly associated with a decreased risk of vascular complication in the PADUA score (OR = 0.110; 95%CI = 0.013-0.938; P = 0.044).
The renal anatomic classification system cannot predict the occurrence of vascular complications after partial nephrectomy.
使用 PADUA、RENAL 和 ZS 评分确定肾肿瘤复杂性与部分肾切除术后血管并发症之间的关系。
2007 年 1 月至 2018 年 12 月，共有 1917 名具有可用的横断面成像的患者纳入研究。使用逻辑回归来确定血管并发症的独立预测因素。
在 1917 名患者中，有 31 名（1.6%）发生血管并发症，包括 10 名女性和 21 名男性。在 PADUA（OR=0.256；95%CI=0.086-0.762；P=0.014）和 ZS 评分中，高复杂度类别与血管并发症的风险降低显著相关，（OR=0.279；95%CI=0.083-0.946；P=0.040）。腹腔镜部分肾切除术和机器人辅助腹腔镜部分肾切除术是血管并发症的独立危险因素。同时，在 PADUA 评分中，高评分肿瘤组中仅在最近 4 年血管并发症的发生率显著降低（0.2%[1/474] vs. 2.2%[3/139]，P=0.038）和 ZS 评分（0.2%[1/469] vs. 2.7%[3/112]，P=0.024）。在前 8 年中，腹腔镜部分肾切除术和机器人辅助腹腔镜部分肾切除术是血管并发症的唯一两个独立危险因素。在最近的 4 年中，只有 PADUA 评分中的高复杂性类别与血管并发症的风险降低显著相关（OR=0.110；95%CI=0.013-0.938；P=0.044）。
肾解剖分类系统不能预测部分肾切除术后血管并发症的发生。
