The association of anatomical renal mass complexity with surgical approach, Hb drop, and the rate of blood transfusion

Autor: Shakhawan Hama Amin Said, Lusan Abdulhameed Arkawazi Saiwan, Mzhda Sahib Jaafar, Nadhm Kanabi Majeed, Rawa Bapir, Ismaeel Aghaways, Abdullah A. Qadir, Berun A. Abdalla, Ayoob Asaad Mohammed Abid, Fahmi H. Kakamad
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Archivio Italiano di Urologia e Andrologia, Vol 96, Iss 3 (2024)
Druh dokumentu: article
ISSN: 1124-3562
2282-4197
DOI: 10.4081/aiua.2024.12496
Popis: Introduction: The third most prevalent malignant neoplasm involving the urinary tract is renal cell carcinoma (RCC), encompassing nearly 3.5% of the entire cancers afflicting the body. The aim of this research was to explore how the R.E.N.A.L. nephrometry score relates to the decisions made regarding surgery in individuals with localized RCC. Methods: This prospective study, assessed patients with localized parenchymal renal masses (stages I and II) tentatively diagnosed as RCC. Utilizing preoperative multiphasic renal CT scans and MRI, the R.E.N.A.L. score categorized masses for nephrometry values. Inclusion criteria involved collecting patient data, and data collection utilizing a structured format focusing on the nephrometry grading system. Results: The study included 64 patients aged (mean ± SD) 49.78 ± 12.35 yrs. Undergoing renal mass surgery, there were 17 (26.5%) low, 28 (43.8%) moderate and 19 (29.7%) high-complexity lesions. All patients with a low Nephrometry score (n = 17) underwent partial nephrectomy, and all cases with a high score (n = 19) underwent radical nephrectomy. For those with a moderate Nephrometry score (n = 28), 13 (46.4%) underwent partial nephrectomy, while the remaining 15 (53.6%) cases underwent radical nephrectomy. Morbidity was low, and no mortality occurred at 180 days. Patients who had lesions fully above or below polar lines were less likely to need blood transfusions. A trend towards higher Fuhrman grades in patients receiving transfusions suggests a potential link between tumor aggressiveness and bleeding risk. Conclusions: Our findings provide insight on the utilization of the R.E.N.A.L. nephrometry score in forecasting perioperative, post-surgical, and oncological results. Such data might help optimize surgical methods and pre-operative patient counseling.
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