MP68-15 DOES UTILIZING IRIS, A SEGMENTED THREE-DIMENSIONAL MODEL, PRESERVE RENAL PARENCHYMAL VOLUME DURING ROBOTIC PARTIAL NEPHRECTOMY?

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP68-15 DOES UTILIZING IRIS, A SEGMENTED THREE-DIMENSIONAL MODEL, PRESERVE RENAL PARENCHYMAL VOLUME DURING ROBOTIC PARTIAL NEPHRECTOMY? Teona Iarajuli, Christina Caviasco, Tanner Corse, Katherine Kim, Jennifer Nguyen, Ruth Sanchez DE LA Rosa, Simon Gelman, Nick Spagnuolo, Hannah Sidoti, Mitchell Miller, and Michael Stifelman Teona IarajuliTeona Iarajuli More articles by this author , Christina CaviascoChristina Caviasco More articles by this author , Tanner CorseTanner Corse More articles by this author , Katherine KimKatherine Kim More articles by this author , Jennifer NguyenJennifer Nguyen More articles by this author , Ruth Sanchez DE LA RosaRuth Sanchez DE LA Rosa More articles by this author , Simon GelmanSimon Gelman More articles by this author , Nick SpagnuoloNick Spagnuolo More articles by this author , Hannah SidotiHannah Sidoti More articles by this author , Mitchell MillerMitchell Miller More articles by this author , and Michael StifelmanMichael Stifelman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003331.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Preservation of renal parenchymal volume is one of the major goals of surgeons performing a partial nephrectomy (PN). IRIS anatomical visualization software generates a segmented 3D model, allowing surgeons to better visualize the tumor, renal vasculature, collecting system, and their relationship. We hypothesize that using a segmental 3D model intra-operatively during PN on complex tumors would improve renal parenchymal volume preservation. METHODS: We identified 74 non-IRIS and 19 IRIS patients who underwent PN from January 1st, 2019 to January 1st, 2022, with nephrometry scores of 9, 10, 11, and had complete pre and postoperative axial imaging. We completed propensity score matching (PSM) based on nephrometry score, age, BMI, and tumor volume and finalized 18 PS matched pairs. Pre and postoperative imaging (MRI or CT) were obtained from patient charts on Fuji PACS and quality screened by our researchers. Volumes of the preoperative renal tumor mass and whole kidney volume were obtained and used to calculate predicted postoperative volume. Measured postoperative renal volumes were compared to the predicted postoperative volumes. Statistical analysis was performed using a paired one-sided t-test. All analyses were performed using R. RESULTS: The mean predicted postoperative kidney volume in the IRIS and non-IRIS groups were 194.1 cm3 (71.5) and 218.9 cm3 (SD=48.9), and postoperative whole kidney volume was 175.0 cm3 (SD=73.5) and 186.9 cm3 (SD=47.2). Mean difference between predicted and actual postoperative whole kidney volume in the IRIS group was statistically smaller, 19.2 cm3 (SD=20.2), than the non-IRIS group, 32 cm3 (SD=16.1, p=0.0074). Percent difference from predicted kidney volume in the IRIS group was 10.9% vs. 17.1% in the non-IRIS group. There was no significant change in mean GFR from baseline to 6-month postoperative period between IRIS and non-IRIS groups (-6.39, SD=15.8 vs. -9.54, SD=13.3; p=0.374). Additionally, no significant difference in complication rates (0 vs. 1, p=0.235), frequency of patients who experienced worsening GFR staging (5 vs 4, p=1.00) and >25% decrease in GFR levels (3 vs. 4, p=1.00) were found between IRIS and non-IRIS groups respectively. CONCLUSIONS: We demonstrated that using a segmental 3D model intra-operatively when performing a partial nephrectomy on complex tumors improves renal parenchymal preservation. The long-term clinical significance of this preservation remains to be determined. Source of Funding: No Funding © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e959 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Teona Iarajuli More articles by this author Christina Caviasco More articles by this author Tanner Corse More articles by this author Katherine Kim More articles by this author Jennifer Nguyen More articles by this author Ruth Sanchez DE LA Rosa More articles by this author Simon Gelman More articles by this author Nick Spagnuolo More articles by this author Hannah Sidoti More articles by this author Mitchell Miller More articles by this author Michael Stifelman More articles by this author Expand All Advertisement PDF downloadLoading ...