一项基于术前ABC评分系统评估后腹腔镜肾部分切除术难度及并发症发生率的临床应用

目的探索ABC评分系统在评估后腹腔镜肾部分切除术的手术难度及并发症发生率的临床应用价值。方法回顾性分析2013年6月至2018年1月行后腹腔镜肾部分切除术患者的临床病理资料,分析ABC评分系统与手术时间、热缺血时间以及出血量的相关性,多因素Logistic回归分析确定术后并发症发生率的独立预测参数。结果共纳入75例患者。ABC评分与手术时间和热缺血时间有显著相关性(P<0.01),但与出血量无相关性(P>0.05)。ABC评分是术后总并发症发生率的独立预测参数,以ABC 1级为参考评分,ABC 2级、ABC 3S级和ABC 3H级的比值比(95%置信区间值)分别是5.310(1.087~25.950)、6.040(1.071~34.081)和21.155(3.074~145.594)。结论ABC评分具有预测后腹腔镜肾部分切除术的手术时间、热缺血时间以及并发症发生率的能力,但仍需要大型的前瞻性研究明确其临床应用价值。

A clinical system to assess the difficulty and complications of retroperitoneal laparoscopic partial nephrectomy based on preoperative ABC scoring system

Objective To explore the clinical significance of arterial based complexity(ABC)scoring system in evaluating the difficulty and complications of retroperitoneal laparoscopic partial nephrectomy(RLPN).Methods The clinicopathological information of patients who underwent RLPN during Jun.2013 and Jan.2018 were retrospectively analyzed.The correlation between ABC scoring system and operation time,warm ischemia time and estimated blood loss was evaluated.The independent predictive parameters of postoperative complications were identified with multivariate Logistic regression analysis.Results In total,75 patients were enrolled.ABC scoring system was significantly related to operation time and warm ischemia time,but not to estimated blood loss.ABC scoring system was the independent predictive parameter of postoperative complications.ABC 1 as the reference,the odds ratio and 95%confidence interval(95%CI)for ABC 2,ABC 3S and ABC 3H were 5.310(1.087-25.950),6.040(1.071-34.081)and 21.155(3.074-145.594),respectively.Conclusion ABC scoring system is able to predict operation time,warm ischemia time and postoperative complications of RLPN.However,further large scale and prospective research is needed to evaluate its clinical significance.