title: The application of R.E.N.A.L. nephrometry scoring system in predicting the complications after laparoscopic renal radiofrequency ablation.
abstract: OBJECTIVE
  To investigate the clinical significance of R.E.N.A.L. nephrometry scoring system in evaluating the complications after laparoscopic radiofrequency ablation (LRFA) of renal tumors.
  
  
  METHODS
  We conducted a retrospective review of the records of all patients who underwent LRFA of renal tumors from February 2006 to March 2012 in our institution. Tumors were categorized as low (4-6), moderate (7-9), or high complexity (10-12) according to R.E.N.A.L. nephrometry score (NS), which was determined by analyzing preoperative imaging. Perioperative data were analyzed to determine the presence of complications.
  
  
  RESULTS
  LRFA was performed on 170 tumors in 170 selected patients with preoperative imaging available. Mean patient age was 55.9 years (range 26 to 81), and mean tumor size was 2.8 cm (range 0.9 to 4.9). Mean NS was 6.6 (range 4 to 12). Of the total tumors, 105 (61.7%) were categorized as low-, 46 (27.1%) as moderate-, and 19 (11.2%) as high-complexity lesions. Overall, there were 21 (12.4%) complications, including 6 (3.6%) grade IIIa and 15 (8.8%) grade I-II complications. There was a significant difference in complication rates among the low- (105 patients, 0%), moderate- (46 patients, 4.3%), and high-complexity (19 patients, 100%) groups, respectively (p<0.05). NS was independently associated with a higher risk of postoperative complications (odds ratio 2.87, 95% CI 1.17-3.04, p=0.02) on multivariate analysis.
  
  
  CONCLUSIONS
  The results of patients undergoing LRFA show that the R.E.N.A.L. NS is independently associated with the occurrence of complications. Therefore, the R.E.N.A.L. nephrometry scoring system is useful in predicting the complication risks of patients who undergo LRFA, and may help with surgical decision making.
authors.affiliation: Department of Urology, The Affiliated Nanjing Drum Tower Hospital, Medical School of Nanjing University , Nanjing, China .
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Chang
authors.forename: Changwei
authors.initials: C
authors.lastname: Ji
authors.forename: Xiaozhi
authors.initials: X
authors.lastname: Zhao
authors.forename: Fan
authors.initials: F
authors.lastname: Zhang
authors.forename: Huibo
authors.initials: H
authors.lastname: Lian
authors.forename: Shiwei
authors.initials: S
authors.lastname: Zhang
authors.forename: Guangxiang
authors.initials: G
authors.lastname: Liu
authors.forename: Gutian
authors.initials: G
authors.lastname: Zhang
authors.forename: Weidong
authors.initials: W
authors.lastname: Gan
authors.forename: Xiaogong
authors.initials: X
authors.lastname: Li
authors.forename: Hongqian
authors.initials: H
authors.lastname: Guo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000009:adverse effects* / Q000379:methods; D003657:Decision Making; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods; D018579:Patient Selection; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D047368:Tumor Burden