Abstract
BackgroundWith the development of three dimensional (3D) reconstruction and printing technology, it has been widely using in the field of urology. However, there have been few studies reporting the role of 3D reconstruction in zero-ischemia partial nephrectomy (PN). The aim of this study was to assess the role of 3D reconstruction and conventional computer tomography angiography (CTA) in zero-ischemia laparoscopic partial nephrectomy (LPN).MethodsA total of 60 consecutive patients undergoing zero-ischemia LPN between October 2017 and March 2018 who underwent CTA (CTA group including 30 patients) and 3D reconstruction (3D group including the remaining 30 patients) preoperatively were included. 3D reconstruction and CTA images were prepared which were used to demonstrate the number and spatial interrelationships of the location of renal tumors and tumor feeding arteries. These radiological findings were directly correlated with intraoperative surgical findings at laparoscopy. Baseline, perioperative variables and the rate of accurate tumor feeding artery orientation were compared between groups.ResultsAll LPNs were completed without conversion to renal hilar clamping or open surgery. Preoperative 3D reconstruction identified that 15 patients had only one tumor feeding artery, 12 had two, and another 3 had three, while the conventional CTA revealed that 22 patients had one tumor feeding artery, 8 had two (P > 0.05). The mean operation time was shorter and estimated blood loss was less in the 3D group (P < 0.05) and the rate of accurate tumor feeding artery dissection was higher in the 3D group (91.7%) in comparison with the CTA group (84.2%). The baseline characteristics and renal function outcomes had no statistical differences between groups.Conclusions3D reconstruction can provide comprehensive information for the preoperative evaluation and intraoperative orientation about tumor feeding arteries that may facilitate tumor resection during zero-ischemia LPN for renal tumors.
Highlights
With the development of three dimensional (3D) reconstruction and printing technology, it has been widely using in the field of urology
We aimed to determine whether Three dimensional (3D) reconstruction could be the preferred preoperative radiological examination, which can provide all necessary information for surgical planning and orientation
computer tomography angiography (CTA) and 3D reconstruction protocol Before the examination of CTA, all patients were administered with one liter of water and a 64multidetector computed tomography scanner (VCT Light Speed, GE Healthcare, Pittsburgh, USA) was utilized to perform CTA
Summary
With the development of three dimensional (3D) reconstruction and printing technology, it has been widely using in the field of urology. The aim of this study was to assess the role of 3D reconstruction and conventional computer tomography angiography (CTA) in zero-ischemia laparoscopic partial nephrectomy (LPN). Helical computerized tomography (CT) could provide high quality images of the renal tumor, vasculature and collecting system as well, three dimensional (3D) reconstruction and printing technology had gained more and more popularity in urological community [5]. These image modality has been utilizing for preoperative assessing of patients undergoing PN [6, 7]. We aimed to determine whether 3D reconstruction could be the preferred preoperative radiological examination, which can provide all necessary information for surgical planning and orientation
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