|Table of Contents|

Application of three-dimensional visualization imaging in robot-assisted partial nephrectomy in the treatment of complex renal tumors

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 07
Page:
1311-1314
Research Field:
Publishing date:

Info

Title:
Application of three-dimensional visualization imaging in robot-assisted partial nephrectomy in the treatment of complex renal tumors
Author(s):
YANG Xiaolong1; CUI Zhenyu2; MA Tao2; YANG Wenzeng2
1.Affiliated Hospital of Hebei University/Clinical Medical College,Hebei Baoding 071000,China；2.Department of Urology,Affiliated Hospital of Hebei University,Hebei Baoding 071000,China.
Keywords:
renal tumor; three-dimensional visualization imaging; robot; partial nephrectomy
PACS:
R737.11
DOI:
10.3969/j.issn.1672-4992.2023.07.025
Abstract:
Objective:To explore the application value of three-dimensional visualization imaging technique in robot-assisted partial nephrectomy (RAPN) in the treatment of complex renal tumors.Methods:The clinical data of 92 patients with complex renal tumors treated in our hospital from May 2020 to August 2022 were analyzed retrospectively.43 patients (group A) underwent three-dimensional visualization imaging before operation,and the other 49 patients (group B) not.The operation time,warm ischemia time,changes of serum creatinine and hemoglobin within 24 hours after operation,postoperative extubation time and postoperative hospital stay were compared between the two groups.Results:The operations in both groups were completed successfully and there was no case of conversion to open surgery.Compared with group B,the warm ischemia time in group A was significantly shortened ［(21.23±0.96) min vs (28.29±0.84) min,P<0.05］,the decrease in hemoglobin within 24 hours after operation was significantly reduced ［(10.40±1.02) g/ L vs (16.65±1.44) g/L,P<0.05］,postoperative hospital stay was significantly shortened ［(7.12±0.15) d vs (11.29±0.88) d,P<0.05］.There was no significant difference in the operation time,the increase of serum creatinine within 24 hours after operation,and the time of extubation after operation between the two groups (P>0.05).One patient in group B developed urinary fistula after operation,and underwent ureteral stent placement on the 3rd day after operation,which improved after operation.Conclusion:Three-dimensional visualization imaging technology can shorten the warm ischemia time,postoperative hospital stay,reduce intraoperative blood loss,and reduce the incidence of complications in the treatment of complex renal tumors with RAPN,which has great clinical application value.

References:

［1］ LJUNGBERG B,ALBIGES L,ABU-GHANEM Y,et al.European association of urology guidelines on renal cell carcinoma:the 2019 update［J］.European Urology,2019,75(5):799-810.
［2］ CAMPBELL S,UZZO RG,ALLAF ME,et al.Renal mass and localized renal cancer:AUA guideline［J］.The Journal of Urology,2017,198(3):520-529.
［3］ MIKHAIL D,SARCONA J,MEKHAIL M,et al.Urologic robotic surgery［J］.Surgical Clinics of North America,2020,100(2):361-378.
［4］ GRIVAS N,KALAMPOKIS N,LARCHER A,et al.Robotassisted versus open partial nephrectomy:comparison of outcomes.A systematic review［J］.Minerva Urol Nefrol,2019,71(2):113-120.
［5］ KUTIKOV A,UZZO RG.The R.E.N.A.L nephrometry score:a comprehensive standardized system for quantitating renal tumor size,location and depth［J］.The Journal of Urology,2009,182(3):844-853.
［6］ 张旭,李宏召,马鑫,等.泌尿外科腹腔镜与机器人手术学［M］.北京:人民卫生出版社,2015:10-14. ZHANG X,LI HZ,MA X,et al.Laparoscopic and robotic surgery in urology［M］. Beijing:People's Health Publishing House,2015:10-14.
［7］ CHECCUCCI E,AMPARORE D,PECORARO A,et al.3D mixed reality holograms for preoperative surgical planning of nephron-sparing surgery:evaluation of surgeons x perception［J］.Minerva Urol Nephrol,2021,73(3):367-375.
［8］ LEPPERT J,LAMBERTS R,THOMAS I,et al.Incident CKD after radical or partial nephrectomy［J］.Journal of the American Society of Nephrology,2018,29(1):207-216.
［9］ JING KJ,SHER YT,KIAN TC.Is partial nephrectomy worth performing compared to radical nephrectomy for small,localised renal cortical tumours in geriatric patients ［J］.Singapore Medical Journal,2020,61(4):190-193.
［10］ HIDEKAZU T,TOSHIO T,TSUNENORI K,et al.Robot-assisted laparoscopic partial nephrectomy versus laparoscopic partial nephrectomy:a propensity score-matched comparative analysis of surgical outcomes and preserved renal parenchymal volume［J］.International Journal of Urology,2018,25(4):359-364.
［11］ BROWN JA,HUBOSKY SG,GOMELLA LG,et al.Hand assisted laparoscopic partial nephrectomy for peripheral and central lesions:a review of 30 consecutive cases［J］.The Journal of Urology,2004,171(4):1443-1446.
［12］ 景泰乐,夏丹,王平,等.机器人辅助腹腔镜下应用第三臂经腹膜外途径保留肾单位手术治疗复杂性肾肿瘤的可行性［J］.中华泌尿外科杂志,2017,38(7):507-510. JING TL,XIA D,WANG P,et al.Utility of the third arm in robot-assisted laparoscopic partial nephrectomy for complex renal tumor［J］.Chinese Journal of Urology,2017,38(7):507-510.
［13］ PORPIGLIA F,CHECCUCCI E,AMPARORE D,et al.Three-dimensional augmented reality robot-assisted partial nephrectomy in case of complex tumours (PADUA>10):A new intraoperative tool overcoming the ultrasound guidance［J］.European Urology,2020,78(4):229-238.
［14］ 张昊,刘鹏,梁芳,等.3D可视化及混合现实技术在肾肿瘤手术治疗和医患沟通中的应用［J］.中华泌尿外科杂志,2021,42(12):890-895. ZHANG H,LIU P,LIANG F,et al.Clinical application of 3D visualization and mixed reality technique in surgical resection of renal tumor［J］.Chinese Journal of Urology,2021,42(12):890-895.
［15］ PORPIGLIA F,FIORI C,CHECCUCCI E,et al.Hyperaccuracy three-dimensional reconstruction is able to maximize the efficacy of selective clamping during robot-assisted partial nephrectomy for complex renal masses［J］.European Urology,2018,74(5):651-660.
［16］ 贾景文,苗东旭,王晓天,等.RENAL评分及其他相关因素对后腹腔镜肾部分切除术中热缺血时间的影响分析［J］.现代肿瘤医学,2018,26(17):2724-2727. JIA JW,MIAO DX,WANG XT,et al.The influence of RENAL score and other related factors on the time of warm ischemia in the retroperitoneal laparoscopic partial nephrectomy［J］.Modern Oncology,2018,26(17):2724-2727.
［17］ ZARGAR H,AKCA O,RAMIREZ D,et al.The impact of extended warm ischemia time on late renal function after robotic partial nephrectomy［J］.Journal of Endourology,2015,29(4):444-448.
［18］ NUMAKURA K,KOBAYASHI M,KOIZUMI A,et al.Factors influencing warm ischemia time in robot-assisted partial nephrectomy change depending on the surgeon's experience［J］.World Journal of Surgical Oncology,2022,20(1):1-6.

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Last Update: 2023-02-28