Three-dimensional reconstruction facilitates off-clamp laparoscopic partial nephrectomy for stage cT1b renal tumors

BACKGROUND: This study aimed to evaluate the role of three-dimensional (3D) reconstruction of T1b renal tumors in the off-clamp laparoscopic partial nephrectomy (LPN). METHODS: A total of 40 consecutive patients undergoing LPN for stage cT1b renal tumor between January 2018 and July 2018 were included. Twenty received off-clamp LPN under the guidance of 3D reconstruction (3D group), and remaining 20 underwent off-clamp LPN under the guidance of conventional computer tomography arteriography (CTA group). The demographics, perioperative characteristics and renal function were compared between groups. RESULTS: All the procedures were performed successfully without conversion to main renal artery clamping. There were no significant differences in the age, gender, body mass index (BMI), tumor size, and RENAL score between two groups. The mean operation time (OT) was significantly shorter and estimated blood loss markedly less in the 3D group than in the CTA group. Incidence of postoperative complications was 5% in the 3D group and 10% in the CTA group (P>0.05). 3D reconstruction of renal tumors resulted in more accurate dissection of the tumor artery (90.9%) as compared to conventional CTA (81.5%). All the patients had negative surgical margins. There was no significant difference in the estimated glomerular filtration rate (eGFR) before and after surgery between two groups. CONCLUSIONS: 3D reconstruction is beneficial for the resection of cT1b renal tumor and tumor-specific feeding arteries in the off-clamp LPN.