title: Application of modified R.E.N.A.L. nephrometry score system in evaluating the retroperitoneal partial nephrectomy for T1 renal cell carcinoma.
abstract: OBJECTIVE
  This study aims to investigate the application of the modified R.E.N.A.L. nephrometry score system in evaluating the operation difficulty of retroperitoneal partial nephrectomy in T1 renal cell carcinoma patients.
  
  
  METHODS
  A total of 52 patients with T1 renal cell carcinoma were enrolled. They all had retroperitoneal partial nephrectomy. Their clinical data was retrospectively analyzed. R.E.N.A.L. nephrometry score system was modified based on the features of retroperitoneal partial nephrectomy. The specificity, sensitivity and Youden index were compared between R.E.N.A.L. nephrometry score system and the modified R.E.N.A.L. nephrometry score system. The effect of the modified R.E.N.A.L. nephrometry score system on perioperative outcomes was analyzed.
  
  
  RESULTS
  Three degrees of operation difficulty were defined by the modified R.E.N.A.L. nephrometry score system, which included the low, medium and high degree of operation difficulty. The specificity, sensitivity and Youden index of the modified R.E.N.A.L. nephrometry score system were better than those of the original R.E.N.A.L. nephrometry score system. Compared with low degree of operation difficulty, patients with medium and high degree of operation difficulty had significantly higher levels of operative time, warm ischemia time, and intraoperative blood loss (P < 0.05). And, the levels of operative time, warm ischemia time, and intraoperative blood loss in patients with high degree were significantly higher than those in patients with medium degree (P < 0.05).
  
  
  CONCLUSIONS
  The modified R.E.N.A.L. nephrometry score system has a good effect in evaluating the operation difficulty of retroperitoneal partial nephrectomy.
authors.affiliation: Department of Urology, First Affiliated Hospital, School of Medicine, Shihezi University Shihezi 832000, P.R. China.
authors.forename: Qinzhang
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Urology, First Affiliated Hospital, School of Medicine, Shihezi University Shihezi 832000, P.R. China.
authors.forename: Biao
authors.initials: B
authors.lastname: Qian
authors.affiliation: Department of Urology, First Affiliated Hospital, School of Medicine, Shihezi University Shihezi 832000, P.R. China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Urology, First Affiliated Hospital, School of Medicine, Shihezi University Shihezi 832000, P.R. China.
authors.forename: Zhao
authors.initials: Z
authors.lastname: Ni
authors.affiliation: Department of Urology, First Affiliated Hospital, School of Medicine, Shihezi University Shihezi 832000, P.R. China.
authors.forename: Yinglong
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Urology, First Affiliated Hospital, School of Medicine, Shihezi University Shihezi 832000, P.R. China.
authors.forename: Xinmin
authors.initials: X
authors.lastname: Wang
keywords: T1 renal cell carcinoma; modified R.E.N.A.L. nephrometry score system; partial nephrectomy; retroperitoneoscopy