Vol. 7, Issue 1, Part A (2025)

Objective: To evaluate the predictive value of the RENAL nephrometry scoring system for perioperative outcomes in laparoscopic partial nephrectomy (LPN) through analysis of 100 consecutive cases at a single institution.
Methods: A retrospective analysis was conducted on prospectively collected data from 100 patients who underwent LPN between January 2021 to October 2023. Two experienced urologists independently calculated RENAL nephrometry scores for each renal mass. Primary outcomes included operative time, warm ischemia time, estimated blood loss, and complications classified using the Clavien-Dindo system. Secondary outcomes encompassed positive surgical margins, length of hospital stay, and changes in renal function.
Results: Of the 100 cases analyzed, tumors were classified as low complexity (38%), moderate complexity (45%), and high complexity (17%) based on RENAL scores. Mean operative time was 185.3±45.6 minutes, with significant differences observed across complexity groups (low: 165.4 vs. high: 218.6 minutes, p<0.001). Mean warm ischemia time was 19.8±6.4 minutes, showing strong correlation with RENAL scores. Overall complication rate was 22%, with major complications (Clavien-Dindo ≥3) occurring in 8% of cases. Complication rates significantly differed by complexity (low: 13.2%, moderate: 22.2%, high: 41.2%, p=0.003). Positive surgical margins were observed in 4% of cases, with higher incidence in the high complexity group.
Conclusions: The RENAL nephrometry scoring system demonstrates robust predictive value for perioperative outcomes in laparoscopic partial nephrectomy. The system effectively stratifies surgical risk and complexity, providing valuable information for preoperative planning, patient counseling, and surgical approach selection. These findings support its routine implementation in clinical practice for optimizing surgical outcomes in partial nephrectomy.