Three-dimensional computed tomography-based resection process map for robot-assisted partial nephrectomy: propensity...

Area of Science:

• Urology
• Surgical Oncology
• Medical Imaging

Background:

• Robot-assisted partial nephrectomy (RAPN) is a standard procedure for kidney tumors.
• Preoperative planning is crucial for optimizing RAPN outcomes.
• Three-dimensional (3D) computed tomography (CT)-based resection process map (RPM) imaging offers detailed visualization for surgical guidance.

Purpose of the Study:

• To evaluate the impact of preoperative 3D CT-based RPM imaging on the outcomes of RAPN.
• To assess the effect of RPM on trifecta achievement and complication rates in RAPN procedures.

Main Methods:

• Retrospective analysis of 177 patients undergoing RAPN.
• Comparison between patients who received RPM imaging (n=92) and those who did not (n=85).
• Propensity score matching was used to control for confounding variables; trifecta achievement rate was the primary endpoint.

Main Results:

• No significant difference in trifecta achievement rates between RPM and non-RPM groups (73.3% vs. 73.3%).
• The RPM group demonstrated significantly fewer Grade 3 or higher complications (0.0% vs. 13.3%, p=0.026).
• Multivariate analysis identified da Vinci Xi system and tumor diameter as independent factors for trifecta achievement.

Conclusions:

• Preoperative 3D CT-based RPM imaging may not influence trifecta achievement in RAPN.
• RPM utilization is associated with a potential reduction in severe perioperative complications.
• Detailed visualization provided by RPM may enhance surgical safety during complex partial nephrectomies.