title: Value of Nephrometry Score Constituents on Perioperative Outcomes and Split Renal Function in Patients Undergoing Minimally Invasive Partial Nephrectomy.
abstract: OBJECTIVE
  To assess the relationship between individual nephrometry score (NS) constituents (RENAL) on perioperative outcomes and renal function of the surgical kidney in patients undergoing laparoscopic partial nephrectomy or robotic-assisted partial nephrectomy.
  
  
  METHODS
  Two hundred forty-five patients who underwent laparoscopic partial nephrectomy or robotic-assisted partial nephrectomy between 2005 and 2014 were retrospectively reviewed. Each renal mass' NS was calculated from preoperative computed tomography imaging. Multivariate regression analysis was used to evaluate the effect of NS variables on perioperative outcomes and change in overall renal function (as estimated by glomerular filtration rate) from preoperative to 1-year postoperative. A cohort analysis assessed the effect of NS variables on change in split renal function of the surgical kidney from pre- to postoperative based on nuclear medicine renal scintigraphy.
  
  
  RESULTS
  Tumor radius (R), endophytic nature (E), and nearness to collecting system (N) variables significantly and incrementally predicted a longer operative time and warm ischemia time. Overall renal function based on glomerular filtration rate was not affected by any NS variable. However, percent function of the surgical kidney by renal scintigraphy significantly decreased postoperatively as R and E values increased.
  
  
  CONCLUSIONS
  R, E, and N were associated with significant changes in warm ischemia time and operative time. R and E were associated with a significant decrease in split renal function of the surgical kidney at 1 year after surgery but not with overall renal function. R, E, and N are the NS constituents most relevant to perioperative outcomes and postoperative differential renal function after partial nephrectomy.
authors.affiliation: Department of Urology, Montefiore Medical Center, Bronx, NY. Electronic address: kara.watts@gmail.com.
authors.forename: Kara L
authors.initials: KL
authors.lastname: Watts
authors.affiliation: Department of Urology, Montefiore Medical Center, Bronx, NY.
authors.forename: Propa
authors.initials: P
authors.lastname: Ghosh
authors.affiliation: Department of Urology, Montefiore Medical Center, Bronx, NY.
authors.forename: Solomon
authors.initials: S
authors.lastname: Stein
authors.affiliation: Department of Urology, Montefiore Medical Center, Bronx, NY.
authors.forename: Reza
authors.initials: R
authors.lastname: Ghavamian
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging* / Q000503:physiopathology; D007677:Kidney Function Tests; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011184:Postoperative Period; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome