scholarly journals Three-dimensional reconstruction facilitates off-clamp laparoscopic partial nephrectomy for stage cT1b renal tumors

2020 ◽  
Vol 9 (3) ◽  
pp. 1528-1535 ◽  
Author(s):  
Xiaorong Wu ◽  
Chao Shen ◽  
Guangyu Wu ◽  
Chen Jiang ◽  
Qibo Fu ◽  
...  
2020 ◽  
Author(s):  
Feiya Yang ◽  
Lianjie Mou ◽  
Nianzeng Xing

Abstract Objective To explore the feasibility of laparoscopic partial nephrectomy(LPN) in the treatment of renal hilar tumors. Methods Clinical data of 290 patients undergoing laparoscopic partial nephrectomy from January 2013 to August 2019 were retrospectively analyzed, including 27 patients with renal hilar tumors and 263 patients with non-hilar renal tumors. Perioperative data and follow-up results were compared between the two groups. Results Tumor size in Group A is smaller(2.97±0.88 vs 3.55±1.46,p<0.05), R.E.N.A.L. nephrometry score of Group A is higher(8.4±1.3 vs 6.5±1.7,p<0.01).The operation time, WIT and intraoperative blood loss in the Group A were slightly higher, but with no statistical difference (p>0.05). There was no significant difference between the two groups in intraoperative ultrasound rate, collection system repair rate, drainage time,postoperative hospital stay, and eGFR changes (p>0.05).The median follow-up period was 40 months. One patient with postoperative pathologic report of angiomyolipoma was found tumor recurrence and was currently undergoing regular reexamination. Conclusion Three-dimensional laparoscopic partial nephrectomy for renal hilar tumors is safe and feasible after detailed preoperative evaluation of the tumor and selection of appropriate surgical strategies.


2019 ◽  
Vol 47 (9) ◽  
pp. 4324-4332 ◽  
Author(s):  
Gang Fan ◽  
Yanbin Meng ◽  
Shuai Zhu ◽  
Mingji Ye ◽  
Mingfeng Li ◽  
...  

Objectives To explore the efficacy of three-dimensional printing physical model-assisted laparoscopic partial nephrectomy (3D-LPN) in patients with renal tumors. Methods We retrospectively assessed all patients who underwent LPN with or without 3D-printed physical model assistance from January 2016 to February 2018 at our institution. The demographic characteristics, operative findings, and clinical outcomes from the procedure were collected and analyzed. Results Sixty-nine patients underwent 3D-LPN and 58 underwent traditional LPN. The groups showed no differences in demographics, RENAL score, surgical approach, operative time, estimated intra-/postoperative blood loss, increased creatinine level, or complications. In the 3D-LPN group, warm ischemia time was shorter, whereas surgery waiting time was longer, compared with those parameters in the LPN group. Subgroup analysis indicated that for patients with RENAL score ≥8, the 3D-LPN group had significantly shorter warm ischemic time and less intraoperative blood loss than the traditional LPN group. Intra- and postoperative hospital complication rates were similar for 3D-LPN and traditional LPN groups (8.7% vs. 13.7%). Conclusions 3D printing provides an additional tool to assist with LPN. Use of a 3D model can assist in planning and performance of LPN in patients with RENAL score ≥8.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Haijie Zhang ◽  
Fu Yin ◽  
Liyang Yang ◽  
Anqi Qi ◽  
Weiwei Cui ◽  
...  

This study was to explore the clinical application value of computed tomography (CT) images based on a three-dimensional (3D) reconstruction algorithm for laparoscopic partial nephrectomy (LPN) in patients with renal tumors. 30 cases of renal cell carcinoma (RCC) patients admitted to the hospital were selected as the research objects and were rolled into two groups using a random table method. The patients who received PLN under the three-dimensional reconstruction and laparoscopic technique were included in the experimental group (group A), and the patients who received LPN using CT images only were included in the control group (group B). In addition, the treatment results of the two groups of patients were compared and analyzed. Results. The effective rate of the established model was 93.3%; the total renal arteriovenous variability of group A (13.3%) was higher than that of group B (6.7%), and the operation time (131.5 ± 32.1 minutes) was much lower than that of group B (158.7 ± 36.2 minutes), showing statistical significance ( P  < 0.05). Conclusion. CT images based on 3D reconstruction algorithms had high clinical application value for LPN in patients with renal tumors, which could improve the efficiency and safety of LPN.


2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Maomao Li ◽  
Yu Ren ◽  
Guobin Weng

Aims. To examine the safety and feasibility of three-dimensional (3-D) laparoscopic partial nephrectomy for clinically complex renal tumors. Materials and Methods. We retrospectively evaluated 76 patients who underwent a 3-D ( n = 42 ; age, 54.6 ± 12.2 years) or two-dimensional (2-D) laparoscopic partial nephrectomy ( n = 34 ; age, 54.8 ± 13.2 years) for renal tumors with RENAL nephrectomy scores of ≥10 points from the same surgical group between January 2017 and April 2020 in Ningbo Urology and Nephrology Hospital. Mean tumor diameter, operation time, warm ischemic time, amount of intraoperative blood loss, postoperative hospitalization time, hospitalization cost, perioperative complication rate, and renal function were compared. Results. The operation time ( 154.6 ± 45.1  min) and warm ischemic time ( 22.5 ± 6.8  min) in the 3-D laparoscopic group were significantly lower than those in the 2-D laparoscopic group ( 193.0 ± 59.2  min, p = 0.001 and 28.7 ± 7.8  min, p = 0.0002 , respectively). No significant differences in amount of intraoperative blood loss ( p = 0.642 ), length of postoperative hospital stay ( p = 0.541 ), perioperative complication rate ( p = 0.860 ), total hospital cost ( p = 0.641 ), and renal function changes including estimated glomerular filtration rate and serum creatinine ( p > 0.05 ) were found between the two groups. Conclusion. Our preliminary experience showed that the 3-D laparoscopic imaging system significantly shortened the operation and renal ischemic times, which are more conducive to partial resection of highly complex renal tumors.


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