Three-dimensional computed tomography-based resection process map for robot-assisted partial nephrectomy: propensity score matching of a single-center retrospective study.
J Surg Oncol
; 129(7): 1311-1324, 2024 Jun.
Article
em En
| MEDLINE
| ID: mdl-38470556
ABSTRACT
BACKGROUND AND OBJECTIVES:
We aimed to examine the effect of preoperative three-dimensional (3D) computed tomography (CT)-based resection process map (RPM) imaging on the outcomes of robot-assisted partial nephrectomy (RAPN).METHODS:
We retrospectively analyzed 177 patients (RPM group, n = 92; non-RPM group, n = 85) who underwent this surgery between November 2012 and April 2022. Patient-specific contrast-enhanced CT images were used to construct an RPM, a 3D representation of the kidney showing the planned tumor resection and a 5 mm safety margin. Outcome analyses were performed using propensity score matching. The primary endpoint was the trifecta achievement rate.RESULTS:
We extracted 90 cases. The trifecta achievement rate showed no significant differences between the RPM (73.3%) and non-RPM groups (73.3%). However, the RPM group had fewer Grade 3 and higher complications (0.0% vs. 13.3%, p = 0.026). The da Vinci Xi (OR 3.38, p = 0.016) and tumor diameter (OR 0.95, p = 0.013) were independent factors affecting trifecta achievement in multivariate analysis. Using RPM imaging was associated with the absence of Grade 3 and higher perioperative complications (OR 5.33, p = 0.036) in univariate analysis.CONCLUSIONS:
Using preoperative 3D CT-based RPM images before RAPN may not affect trifecta achievement, but may reduce serious complication occurrence by providing detailed information on tumor resection.Palavras-chave
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MEDLINE
Assunto principal:
Tomografia Computadorizada por Raios X
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Imageamento Tridimensional
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Pontuação de Propensão
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Procedimentos Cirúrgicos Robóticos
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Neoplasias Renais
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Nefrectomia
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article