3D-Image guided robotic-assisted partial nephrectomy: a multi-institutional propensity score-matched analysis (UroCCR...

Area of Science:

• Urology
• Surgical Oncology
• Medical Imaging

Background:

• Robot-assisted partial nephrectomy (RAPN) is complex and carries risks.
• Effective preoperative planning and intraoperative guidance are crucial for optimal RAPN outcomes.

Purpose of the Study:

• To evaluate the impact of 3D model reconstructions for preoperative planning and intraoperative guidance on RAPN perioperative outcomes.
• To assess if 3D-guided RAPN improves patient safety and surgical results compared to standard RAPN.

Main Methods:

• Retrospective analysis of RAPN cases from a French kidney cancer network database (UroCCR).
• Comparison between 3D-Image guided RAPN (3D-IGRAPN) and a control group using propensity-score matching.
• Analysis of perioperative outcomes including complication rates, renal function (eGFR variation), and trifecta achievement.

Main Results:

• After matching, 3D-IGRAPN showed a significantly lower rate of major complications (3.8% vs. 9.5%).
• Patients undergoing 3D-IGRAPN experienced a smaller decrease in estimated glomerular filtration rate (eGFR) (-5.6% vs. -10.5%).
• The trifecta achievement rate (negative margins, no major complications, and preserved renal function) was higher in the 3D-IGRAPN group (55.7% vs. 45.1%).

Conclusions:

• Utilizing 3D kidney reconstructions for preoperative planning and intraoperative guidance in RAPN significantly lowers complication risks.
• This advanced planning approach improves key perioperative clinical outcomes, including renal function preservation and trifecta achievement.
• 3D-guided RAPN represents a valuable advancement for complex partial nephrectomy procedures.