Özet:

Objective: Many nephrometric scoring systems (NSSs) have been published for use in estimating the outcome of laparoscopic partial nephrectomy (LPN). There are conflicting results about the predictive success of these systems. Here, we aimed to determine to what extent radius, exophytic/endophytic properties of the tumor, nearness of tumor to the deepest portion to the collecting system or sinus, anterior/posterior descriptor and the location relative to the polar lines (RENAL), preoperative aspects and dimensions used for an anatomical (PADUA), diameter-axial-polar (DAP), and arterial based complexity (ABC) scoring systems can be included in the treatment plan favoring LPN. We compared these NSSs for their power to predict surgical outcomes. Materials and Methods: Sixty-two patients who underwent LPN at our clinic were included in this study. Postoperative complication rates, the number of blood transfusions, warm ischemia times (WIT), postoperative hospital stays (PHS), operation times (OT), pathology outcomes, and margin, ischemia, complications (MIC) achievement rates were recorded retrospectively. Total nephrometry scores were calculated from preoperative computed tomography and magnetic resonance imaging images and divided into risk groups. The correlation between nephrometry scores, and surgical outcomes was investigated. Results: Median age [56.21 (31-80) years] of the patients, and median tumor size (38.89) (11-251) mm was determined. Surgical margin positivity (SMP) developed in 6 (9.7%) cases and major complications (Clavien ≥3) developed in 6 (9.7%) cases. Only DAP scores were statistically correlated with rates of MIC achievement, major complication, is blood transfusion, and PHS (p=0.008, 0.018, 0.011 and 0.006, respectively), while RENAL and PADUA scores with WIT and SMP (p=0.001, 0.002 vs p=0.002, 0.011, respectively), while ABC score with only WIT (p=0.002). None of these scores were correlated with OTs. Conclusion: DAP score may be used when planning LPN, especially in predicting MIC achievement and major complication rates.

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