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• W2912202909 abstract "You have accessJournal of UrologyKidney Cancer: Localized IV1 Apr 2014MP59-05 VALIDATION OF THE RENAL PELVIC SCORE: A NOVEL MARKER OF RENAL PELVIC ANATOMY THAT PREDICTS URINE LEAK FOLLOWING PARTIAL NEPHRECTOMY Jeffrey Tomaszewski, Marc Smaldone, Bic Cung, Tianyu Li, Reza Mehrazin, Alexander Kutikov, Rosalia Viterbo, David Chen, Richard Greenberg, and Robert Uzzo Jeffrey TomaszewskiJeffrey Tomaszewski More articles by this author , Marc SmaldoneMarc Smaldone More articles by this author , Bic CungBic Cung More articles by this author , Tianyu LiTianyu Li More articles by this author , Reza MehrazinReza Mehrazin More articles by this author , Alexander KutikovAlexander Kutikov More articles by this author , Rosalia ViterboRosalia Viterbo More articles by this author , David ChenDavid Chen More articles by this author , Richard GreenbergRichard Greenberg More articles by this author , and Robert UzzoRobert Uzzo More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1801AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives We previously developed a novel scoring system of renal pelvic anatomy to predict urine leak following partial nephrectomy (PN). Herein we validate the Renal Pelvic Score (RPS) in an expanded cohort of patients undergoing PN. Methods Our prospective institutional RCC database was utilized to identify all patients undergoing PN for localized RCC from 2006−2013. Patients were classified by RPS as having an intra or extraparenchymal renal pelvis. Multivariate logistic regression models were used to examine the relationship between RPS and urine leak. Results 831 patients (mean age 58±11.6 years; mean CCI 1.2±1.5; 65.1% male) undergoing PN (57.3% robotic) for low (28.9%), intermediate (56.5%), and high complexity (14.5%) localized renal tumors (mean size 3.7±2.3cm, mean NS 6.1±2.6) were included. 54 (6.5%) of patients developed a urine leak. 72 (8.7%) of renal pelvises were classified as intraparenchymal. On univariate analysis following stratification by RPS, groups differed with respect to ECOG PS, ASA class, tumor stage, collecting system entry (CSE), and procedure type (all p values < 0.05). No differences were observed between tumor grade, histologic subtype, surgical margin status, nephrometry score, race, gender, laterality, and the presence of a solitary kidney. Intrarenal pelvic anatomy was associated with a markedly increased risk of urine leak (57.4% vs. 3.0%, p<0.001), secondary intervention (23.6% vs. 1.7%, p<0.001), and prolonged duration of urine leak (p=0.05). After controlling for BMI, NS, procedure type, ASA status, tumor stage, EBL, and ECOG PS, intraparenchymal renal pelvis (OR 24.8 [CI 11.5-53.4]; p<0.001) and CSE (OR 6.1 [CI 2.5-14.9]; p<0.001) were associated with a significantly increased risk of urine leak. Conclusions Herein we validate the ability of the RPS to predict urine leak following open and robotic partial nephrectomy. Elevated pressures within a small intraparenchymal renal pelvis might explain the increased risk. While external validation of the RPS is required, pre-operative identification of patients at increased risk for urine leak should be considered in peri-operative management algorithms. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e651-e652 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Jeffrey Tomaszewski More articles by this author Marc Smaldone More articles by this author Bic Cung More articles by this author Tianyu Li More articles by this author Reza Mehrazin More articles by this author Alexander Kutikov More articles by this author Rosalia Viterbo More articles by this author David Chen More articles by this author Richard Greenberg More articles by this author Robert Uzzo More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2912202909 title "MP59-05 VALIDATION OF THE RENAL PELVIC SCORE: A NOVEL MARKER OF RENAL PELVIC ANATOMY THAT PREDICTS URINE LEAK FOLLOWING PARTIAL NEPHRECTOMY" @default.
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