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The Arterial Based Complexity (ABC) Classification of Spaliviero et al for Predicting Morbidity After a Partial Nephrectomy

Description

Spaliviero et al described an Arterial Based Complexity (ABC) classification system for a partial nephrectomy. The size of transected vessels during the procedure impacts postoperative complications. The authors are from Memorial Sloan Kettering Cancer Center in New York City.


 

Patient selection: partial nephrectomy

 

Parameters:

(1) location of tumor

(2) arteries involved

Location

Arteries

Category

cortex only

interlobular and arcuate

1

extend into renal medulla reaching line drawn through tips of renal papillae

Interlobar

2

extend beyond the line connecting the tips of the renal papillae, into the renal sinus and towards central collecting system

segmental and their branches

3S

near or involving renal hilum

hilar (major branches of the renal artery)

3H

 

The higher the category the greater the risk for various problems during and after surgery:

(1) ischemia time

(2) blood loss

(3) urinary fistula formation

 


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