title: Usefulness of the diameter-axial-polar nephrometry score for predicting perioperative parameters in robotic partial nephrectomy.
abstract: OBJECTIVE
  The present study aimed to verify the association between diameter-axial-polar (DAP) nephrometry and surgical outcomes, postoperative renal function, and perioperative complications in patients undergoing robotic partial nephrectomy (RPN).
  
  
  METHODS
  Diameter-axial-polar nephrometry was assessed using computed tomography or magnetic resonance imaging on 158 patients who received RPN between July 2007 and February 2013. Demographic data, surgical data, and perioperative complications were recorded, and percent change between the preoperative and last estimated glomerular filtration rate (eGFR) was determined. Linear regression analysis was conducted to assess the relationship between the DAP sum score and warm ischemia time (WIT), estimated blood loss (EBL), and percent decrease in eGFR. Multivariable linear regression analysis was conducted to determine the relationship between each DAP scoring parameter and surgical outcomes.
  
  
  RESULTS
  The median patient age was 50.5 years and median DAP sum score was 6. On linear regression, the DAP sum score was associated with WIT and EBL. On multivariable regression, all DAP parameters were associated with WIT, but the polar distance was not associated with EBL. Patients with a higher DAP sum score showed greater decrease in eGFR after RPN. Patients with a DAP sum score of 6 or higher had a higher risk of major complications than those with a DAP sum score below 6.
  
  
  CONCLUSIONS
  Diameter-axial-polar nephrometry predicted WIT and EBL in patients who underwent RPN. It was also associated with the decrease in eGFR and rate of major perioperative complications, and thus can be useful for surgical planning or patient counseling before RPN.
authors.affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea.
authors.forename: Young Eun
authors.initials: YE
authors.lastname: Yoon
authors.forename: Kyung Hwa
authors.initials: KH
authors.lastname: Choi
authors.forename: Kwang Suk
authors.initials: KS
authors.lastname: Lee
authors.forename: Kwang Hyun
authors.initials: KH
authors.lastname: Kim
authors.forename: Koon Ho
authors.initials: KH
authors.lastname: Rha
authors.forename: Young Deuk
authors.initials: YD
authors.lastname: Choi
authors.forename: Woong Kyu
authors.initials: WK
authors.lastname: Han
mesh_terms: D000328:Adult; D000886:Anthropometry; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology*; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D010535:Laparoscopy; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D009929:Organ Size; D011183:Postoperative Complications / Q000453:epidemiology*; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden; D052096:Warm Ischemia / Q000706:statistics & numerical data