DDD score for renal tumor: An intuitive and comprehensive anatomical scoring system to access the outcomes of retroperitoneal laparoscopic partial nephrectomy

• Published in: International journal of urology 2019-04, Vol.26 (4), p.451-456
• Main Authors: Zhang, Zhong‐Yuan, Pan, Xi, Fan, Yu, Shen, Cheng, Yu, Wei, Han, Wen‐Ke, Lin, Jian, Wang, Gang, Song, Yi, Zhao, Zheng, Hao, Jin‐Rui, Li, Xue‐Song, Wang, He, Wang, Xiao‐Ying, Zhang, Xiao‐Chun, Zhou, Li‐Qun
• Format: Article
• Language: English
• Subjects: carcinoma; Depth perception; Glomerular filtration rate; Ischemia; Kidneys; laparoscopic; Laparoscopy; Nephrectomy; outcome; renal cell; Surgery; Tumors
• ISSN: 0919-8172; 1442-2042
• DOI: 10.1111/iju.13903

Objective To present a DDD scoring system in assessing the complexity and outcomes of retroperitoneoscopic nephron‐sparing surgery for kidney tumor. Methods We retrospectively evaluated 232 patients who underwent retroperitoneoscopic nephron‐sparing surgery between January 2013 and September 2017 for a renal tumor. Both the DDD score and RENAL score were used to classify the tumors. The DDD score consisted of the maximal tumor diameter inside the kidney, the maximal tumor depth into the medulla or collecting system and the minimal distance from the tumor to the main renal vessels. Results The DDD scoring systems were significantly associated with warm ischemia time (P = 0.007) and estimated blood loss (P = 0.017). There was an insignificant positive correlation between the DDD score and the operative time (P = 0.051). Meanwhile, the RENAL score had a significant correlation with the decreasing value of the estimated glomerular filtration rate. Patients with high or moderate DDD scores had a 13.6‐fold or 8.4‐fold risk of overall complications than those with low DDD scores, respectively (all P