Li et al reported the Zero Ischemia Index (ZII) for a patient with a renal tumor undergoing partial nephrectomy. The authors are from Fudan University in Shanghai.
Patient selection: renal tumor suitable for partial nephrectomy
Parameters:
(1) length of the line in cm connecting the 2 points where the tumor crosses the renal capsule (Ri)
(2) distance from the inner edge of the tumor to the line in item 1, drawn perpendicular, in cm (Hi)
zero ischemia index =
= (Ri) * MAX(0.5,Hi)
Interpretation:
• An index > 6 is associated with worse outcomes for an off-clamp partial nephrectomy.
ZII <= 6
ZII >6
blood loss >= 500 ,L
8%
38%
OR time > 2 hours
9%
38%
overall complications
15%
63%
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