Navigation of Intelligent/Interactive Qualitative and Quantitative Analysis Three-Dimensional Reconstruction Technique in Laparoscopic or Robotic Assisted Partial Nephrectomy for Renal Hilar Tumors

J Endourol. 2019 Aug;33(8):641-646. doi: 10.1089/end.2018.0570. Epub 2019 Mar 15.

Abstract

Purpose: To evaluate the feasibility and effectiveness of the navigation of intelligent/interactive qualitative and quantitative analysis (IQQA) three-dimensional (3D) reconstruction technique in laparoscopic or robotic assisted partial nephrectomy (LPN or RAPN) for renal hilar tumors. Patients and Methods: The study retrospectively reviewed 26 patients with hilar tumors from February 2016 to February 2018. IQQA 3D reconstruction technique was applied for the purpose of navigation and resection of the tumors. Relevant clinical parameters and surgical outcomes were recorded. Results: All 26 LPN or RAPN were effectively completed without conversion to a hand-assisted or an open approach. Under the navigation of IQQA, all tumors were found precisely at the first time during surgeries. The mean operative time was 142 minutes (142 ± 35), with a mean warm ischemia time of 24.3 minutes (24.3 ± 9.5). The estimated blood loss was 156 mL (156 ± 112). No intraoperative complications occurred. Two patients suffered from postoperative complications. All patients had negative margins on the final pathological examination. At a mean follow-up period of 3 months, the mean glomerular filtration rate is 22.5 mL/min (22.5 ± 7.1) without tumor recurrence. Conclusions: With peculiar features, such as accurate location, complete resection, and fewer perioperative complications, the navigation of IQQA 3D reconstruction technique in partial nephrectomy represents a safe and effective procedure for hilar tumors.

Keywords: partial nephrectomy; renal cell carcinoma; renal hilar tumor; surgery navigation; three-dimensional reconstruction.

MeSH terms

  • Adult
  • Aged
  • Blood Loss, Surgical
  • Carcinoma, Renal Cell / diagnostic imaging
  • Carcinoma, Renal Cell / pathology
  • Carcinoma, Renal Cell / surgery*
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Imaging, Three-Dimensional
  • Kidney Neoplasms / diagnostic imaging
  • Kidney Neoplasms / pathology
  • Kidney Neoplasms / surgery*
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Multidetector Computed Tomography
  • Nephrectomy / methods*
  • Operative Time
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Robotic Surgical Procedures / methods*
  • Surgery, Computer-Assisted / methods*
  • Warm Ischemia / statistics & numerical data