Clinical Study of Three-Dimensional Laparoscopic Partial Nephrectomy for the Treatment of Highly Complex Renal Tumors with RENAL Nephrometry Scores of ≥10 Points.

Abstract

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.

• Authors: Maomao Li, Yu Ren, Guobin Weng
• Journal: BioMed research international (Biomed Res Int) Vol. 2020 Pg. 5824209 ( 2020) ISSN: 2314-6141 [Electronic] United States
• PMID: 33381559 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 Maomao Li et al.

Topics

• Adult
• Aged
• Female
• Glomerular Filtration Rate
• Hospitalization
• Humans
• Imaging, Three-Dimensional (methods)
• Intraoperative Period
• Kidney Neoplasms (surgery)
• Laparoscopy (methods)
• Male
• Middle Aged
• Nephrectomy (methods)
• Operative Time
• Patient Safety
• Perioperative Period
• Postoperative Complications
• Retrospective Studies
• Risk
• Severity of Illness Index