Factors Affecting Preserved Renal Volume and Function After Laparoscopic Partial Ne-phrectomy: A Long-Term 3D...

Area of Science:

• Nephrology
• Urology
• Surgical Oncology

Background:

• Laparoscopic partial nephrectomy (LPN) is a standard treatment for renal tumors.
• Assessing long-term renal volume and function post-LPN is crucial for patient management.
• 3D modeling offers advanced visualization for surgical assessment.

Purpose of the Study:

• To evaluate long-term changes in renal volume and function following LPN using 3D modeling.
• To identify key predictors of renal function decline and parenchymal volume loss after LPN.

Main Methods:

• Retrospective analysis of 187 patients undergoing LPN (Oct 2012 - Jan 2023).
• Pre- and postoperative cross-sectional imaging with minimum 1-year follow-up.
• 3D Slicer software used for renal volume reconstruction.

Main Results:

• Mean renal parenchymal volume decreased from 168.87 cm³ preoperatively to 137.6 cm³ at 5 years postoperatively.
• Estimated glomerular filtration rate (eGFR) declined from 90.6 to 75.9 mL/min/1.73 m² over the same period.
• Predictors of eGFR decline included parenchymal volume loss, age, female gender, diabetes mellitus, and tumor contact surface area.

Conclusions:

• While preserved renal volume is key early on, diabetes mellitus is the primary long-term determinant of renal function post-LPN.
• Surgical technique and operative time influence parenchymal volume preservation.
• Enucleation may improve parenchymal preservation without compromising oncological outcomes.