Three-dimensional Virtual Models' Assistance During Minimally Invasive Partial Nephrectomy Minimizes the Impairment of Kidney Function
Copyright © 2021 European Association of Urology. Published by Elsevier B.V. All rights reserved..
Three-dimensional virtual models (3DVMs) are nowadays under scrutiny to improve partial nephrectomy (PN) outcomes. This report aims to analyze their impact on renal function preservation after minimally invasive PN. A total of 100 patients treated with minimally invasive PN with contrast-enhanced computed tomography from which a 3DVM was obtained, and having undergone baseline and 3rd month postoperative renal scans were prospectively enrolled and compared with a control group of 251 patients without 3DVMs. Weighted differential of pre- and postoperative renal scan-based effective renal plasmatic flow (b-WD ERPF) was calculated, according to the availability of 3DVMs and PADUA risk category. Multivariable logistic regression (MLR) models predicting a significant loss of renal function (LORF; ERPF drop >20%) were performed, overall and according to PADUA risk categories. The b-WD ERPF of the 3DVM group showed significantly lower LORF (-10%) than that of the control group (-19.6%, p = 0.02). In MLR, the availability of a 3DVM was found to be the only protective factor against a significant LORF (odds ratio [OR] = 0.3, p = 0.002). Moreover, after stratification as per tumor surgical complexity, this protective role was observed in both PADUA 8-9 and ≥10 category risk patients (OR = 0.3, p = 0.03 and OR = 0.1, p = 0.01). PATIENT SUMMARY: The drop in operated kidney function was significantly lower in surgeries assisted by three-dimensional virtual models (3VDMs), indicating that the availability of a 3VDM is the only protective factor against a significant functional damage.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:5 |
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| Enthalten in: |
European urology oncology - 5(2022), 1 vom: 20. Feb., Seite 104-108 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Amparore, Daniele [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 04.05.2022 Date Revised 04.05.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.euo.2021.04.001 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM324565623 |
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| 520 | |a Three-dimensional virtual models (3DVMs) are nowadays under scrutiny to improve partial nephrectomy (PN) outcomes. This report aims to analyze their impact on renal function preservation after minimally invasive PN. A total of 100 patients treated with minimally invasive PN with contrast-enhanced computed tomography from which a 3DVM was obtained, and having undergone baseline and 3rd month postoperative renal scans were prospectively enrolled and compared with a control group of 251 patients without 3DVMs. Weighted differential of pre- and postoperative renal scan-based effective renal plasmatic flow (b-WD ERPF) was calculated, according to the availability of 3DVMs and PADUA risk category. Multivariable logistic regression (MLR) models predicting a significant loss of renal function (LORF; ERPF drop >20%) were performed, overall and according to PADUA risk categories. The b-WD ERPF of the 3DVM group showed significantly lower LORF (-10%) than that of the control group (-19.6%, p = 0.02). In MLR, the availability of a 3DVM was found to be the only protective factor against a significant LORF (odds ratio [OR] = 0.3, p = 0.002). Moreover, after stratification as per tumor surgical complexity, this protective role was observed in both PADUA 8-9 and ≥10 category risk patients (OR = 0.3, p = 0.03 and OR = 0.1, p = 0.01). PATIENT SUMMARY: The drop in operated kidney function was significantly lower in surgeries assisted by three-dimensional virtual models (3VDMs), indicating that the availability of a 3VDM is the only protective factor against a significant functional damage | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Kidney cancer | |
| 650 | 4 | |a Laparoscopy | |
| 650 | 4 | |a Nephron-sparing surgery | |
| 650 | 4 | |a Robotic surgery | |
| 650 | 4 | |a Three-dimensional imaging | |
| 700 | 1 | |a Pecoraro, Angela |e verfasserin |4 aut | |
| 700 | 1 | |a Checcucci, Enrico |e verfasserin |4 aut | |
| 700 | 1 | |a Piramide, Federico |e verfasserin |4 aut | |
| 700 | 1 | |a Verri, Paolo |e verfasserin |4 aut | |
| 700 | 1 | |a De Cillis, Sabrina |e verfasserin |4 aut | |
| 700 | 1 | |a Granato, Stefano |e verfasserin |4 aut | |
| 700 | 1 | |a Angusti, Tiziana |e verfasserin |4 aut | |
| 700 | 1 | |a Solitro, Federica |e verfasserin |4 aut | |
| 700 | 1 | |a Veltri, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Fiori, Cristian |e verfasserin |4 aut | |
| 700 | 1 | |a Porpiglia, Francesco |e verfasserin |4 aut | |
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