THE ROLE OF R.E.N.A.L NEPHROMETRY SCORE TO PREDICT PERIOPERATIVE OUTCOME FOLLOWING PARTIAL NEPHRECTOMY IN A NATIONAL REFERRAL HOSPITAL

Objective: This study aim to see the significance of R.E.N.A.L-NS in our center. Material & Methods: We retrospectively collected all the data of RCC patients that underwent partial nephrectomy (PN) in Cipto Mangunkusumo Hospital from January 2010-January 2018, with complete CT-scan examination. Patients with single kidney were excluded from our study. We evaluated intraoperative blood loss, length of operation, post operative length of stay, post operative kidney function, and complications as the perioperative parameters. Patients were categorized into 3 category based their complexity from RENAL-NS into: low (4-6), moderate (7-9), and high (10-12). Complications were based on Clavien-Dindo classification. Perioperative outcomes were analyzed based on the stratification of the patients and analyzed using ANOVA and chi-square. Results: We evaluated 25 partial nephrectomy cases which are suitable with inclusion and exclusion criteria. There were 8 (32%) low, 14 (56%) medium, and 3 (12%) high complexity cases. Median age of patients were 61 (46-71) years old, with mean tumor diameter 72.07 (+ 38.9) mm. Nine (36%) patients underwent open procedure and 16 (64%) underwent laparoscopic procedure. The laparoscopic procedure was tend to the lower complexity of R.E.N.A.L score (p=0.048).  Higher complexity of R.E.N.A.L score correlated with higher blood loss (p<0.001), length of stay (p<0.001), complication rate (p<0.001), and length of operation (p=0.033). Conclusion: R.E.N.A.L-NS has a role for a selection of type of procedure and a prediction of perioperative outcome in partial nephrectomy.  R.E.N.A.L-NS can be used in daily basis as it could determine the procedure and several outcomes of the partial nephrectomy procedure.