1.Predicting the surgical difficulty,complications and prognosis of kidney tumors based on anatomical features:advances in renal tumor scoring systems
Gen LI ; Yuhao YU ; Xuexing FAN ; Jincheng LI ; Jiasong LI ; Pugui LI ; Xiaopen CHEN ; He WANG ; Geng ZHANG ; Yong WANG
Journal of Modern Urology 2025;30(4):355-363
Renal tumor scoring systems can describe the anatomical characteristics of renal tumors. It is an important standard to evaluate the surgical complexity and to evaluate the surgical complexity and feasibility of partial nephrectomy. Scholars at home and abroad have established various scoring systems based on different anatomical parameters,such as R.E.N.A.L.,PADUA,C-Index,which are used to guide the clinical selection of surgical modalities,and predict perioperative complications and prognosis. In this paper,various scoring systems are grouped into three major categories according to their functions:prediction of surgical complexity,prediction of complications,and prediction of prognosis. The contents,characteristics and clinical application value of various renal tumor scoring systems are introduced in detail to guide urologists,enhance their surgical decision-making ability,and improve the clinical outcomes.
2.Efficacy of modified pelvic floor reconstruction in non-nerve-sparing robot-assisted radical prostatectomy
Xuexing FAN ; Gen LI ; Jincheng LI ; Jiasong LI ; Yuhao YU ; Pugui LI ; Xiaopeng CHEN ; Zhiguo LU ; Geng ZHANG ; Yong WANG
Journal of Modern Urology 2025;30(12):1038-1042,1063
Objective To evaluate the efficacy and safety of modified pelvic floor reconstruction in non-nerve-sparing robot-assisted radical prostatectomy (NNS RARP) for improving postoperative urinary control. Methods A retrospective analysis was conducted on the clinical data of 79 prostate cancer patients who underwent NNS RARP at Tangdu Hospital during Jan.2020 and Dec.2023, including 29 in the reconstruction group, and 50 in the non-reconstruction group. The baseline characteristics including age, body mass index, prostate-specific antigen (PSA) level, clinical stage, prostate volume, and biopsy Gleason score, and perioperative indexes including operation time, intraoperative blood loss, catheter indwelling time, complication rate, and positive rate of surgical margins were compared between the two groups. Additionally, urinary continence function was assessed before operation and 1,3,6, and 12 months after operation using the international consultation on incontinence questionnaire-short form (ICIQ-SF) and the incontinence quality of life questionnaire score (I-QoL). Results No statistically significant differences were observed in the baseline characteristics between the two groups (P>0.05). The operation time was significantly longer in the reconstruction group than in the non-reconstruction group [ (110.24±15.08) min vs. (101.80±9.89) min, P=0.010]. There were no significant differences in intraoperative blood loss, catheter indwelling time, complication rate, and positive rate of surgical margins between the two groups (P>0.05). The reconstruction group demonstrated significantly lower ICIQ-SF scores at 1 month [ (10.17±2.16) vs. (11.56±1.66), P=0.002],3 months [ (7.62±1.29) vs. (9.52±1.80), P<0.001], and 6 months postoperatively [ (4.93±1.22) vs. (6.18± 1.67), P=0.001]compared to the non-reconstruction group (adjusted P<0.0125). Conversely, the I-QoL scores were significantly higher in the reconstruction group at 1 month [ (73.32±10.30) vs. (63.88±9.55), P<0.001]and 3 months postoperatively [ (78.91±4.82) vs. (75.66±5.17), P=0.007] (adjusted P<0.0125). However, no significant differences were found in ICIQ-SF or I-QoL scores between the two groups preoperatively and 12 months postoperatively (adjusted P>0.0125). Conclusion The application of modified pelvic floor reconstruction technique in NNS RARP is safe and feasible. Although it slightly prolongs the operation time, it does not increase surgical risks; instead, it effectively promotes early recovery of postoperative urinary continence, thereby significantly enhancing patients'quality of life.

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