Nephrometry R.E.N.A.L. score interobserver = Sistema de puntaje para nefrometrí­a R.E.N.A.L. score interobservador [documento electrónico] / John Jairo Zuleta Tobón, ; Catalina Cuervo Valencia, ; Carlos Humberto Martínez González, ; José Jaime Correa Ochoa,  . - 2016.
Obra : Urología Colombiana

Idioma : Inglés (eng)

Palabras clave :	Nephrometry  R.E.N.A.L. score  Interobserver  Renal carcinoma  Partial nephrectomy  Ischemia
Resumen :	Introduction: Kutikov and Uzzo described the R.E.N.A.L. nephrometry score in 2009. It allows the anatomic evaluation of renal tumors in order to compare the technical difficulty during partial nephrectomy according to several characteristics: size, depth of the mass in the renal parenchyma, proximity to the renal collecting system, localization (anterior or posterior and polar). The score is also useful, among others, to predict technical difficulty, define the risk of post-operative complications, define the type of ischemia and standardize dada compilation. Materials and methods: We retrospectively reviewed 20 triphasic computed tomography studies from 20 patients that were taken to partial nephrectomy in the Pablo Tobon Uribe Hospital in Medellin between December of 2009 and March of 2014. One urologic oncologist, one radiologist and one urology resident (first year resident) used the nephrometry score to classify the patients. The inter-observer concordance was defined for each of the components by kappa coefficient. Results: Concordance for each score component was analyzed separately. The concordance for tumor diameter component was accurate, 0.75 (confidence interval [CI] 95% 0.34–0.98); for the exofitic/endofitic component was adequate 0.56 (CI 95% 0.30–0.81); for proximity to the collecting system was discordant 0.24 (CI 95% −0.08 to 0.56); for anterior/posterior was concordant 0.65 (CI 95% 0.40–0.89) and for location in relation to the interpolar lines was discordant 0.12 (CI 95% −0.14 to 0.38). Conclusions: We found in this cohort that the R.E.N.A.L. nephrometry score has a good inter-observer concordance for tumor diameter and anterior/posterior components while it was discordant and acceptable for the proximity to the collecting system and relation to the inter-polar lines respectively. The R.E.N.A.L. nephrometry score is a useful tool to establish the best surgical approach, technical difficulty and type of ischemia during partial nephrectomy.
Mención de responsabilidad :	Gustavo López Ochoa, John Jairo Zuleta, Catalina Valencia, Carlos Martínez, José Jaime Correa
DOI (Digital Object Identifier) :	10.1016/j.uroco.2015.11.004
En línea :	https://linkinghub.elsevier.com/retrieve/pii/S0120789X16300338
Enlace permanente :	https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4630