European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2026
Preoperative three-dimensional reconstruction facilitates robot-assisted radical nephrectomy and inferior vena cava thrombectomy for renal cell carcinoma: Insights from a Chinese high-volume center.
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Hong Peng, Yu Le, Duan Peichen, Zhang Fan, Deng Shaohui, Wang Guoliang, Zhang Shudong
Аннотация
OBJECTIVE: Three-dimensional (3D) reconstruction model is an emerging technology that significantly enhanced perioperative metrics. This work aimed to delineate the contribution of preoperative 3D reconstruction model to robot-assisted radical nephrectomy (RARN) and IVC thrombectomy.
METHODS: A retrospective cohort study was conducted on consecutive patients with RCC and IVC tumor thrombus (Mayo level 1-3) who underwent robotic surgery by a single surgeon (January 2023-January 2026). Preoperative computed tomography urography (CTU) images were used to generate 3D reconstruction models, enabling detailed visualization of tumor-vessel relationships and quantitative measurement of tumor parameters. The primary oncological endpoint was recurrence-free survival (RFS); overall survival (OS) was also evaluated as a secondary endpoint. Postoperative complications were graded using Clavien-Dindo (≥III defined as major), and renal function was assessed by eGFR. A two-sided p value < 0.05 was considered significant.
RESULTS: Among 71 patients, those with preoperative 3D reconstruction (n = 27) versus without (n = 44) showed significantly shorter postoperative hospital stay (8.0 vs 10.0 days, P = 0.04) and higher postoperative estimated glomerular filtration rate (eGFR) (76.0 vs 60.0, P = 0.01). Other perioperative benefits (blood transfusion, major complications) were not statistically significant. RFS and OS did not differ significantly between groups.
CONCLUSIONS: Preoperative 3D reconstruction helps facilitate RARN and IVC thrombectomy and improves perioperative outcomes. This technique holds promise for broader application in complex urological surgery.
METHODS: A retrospective cohort study was conducted on consecutive patients with RCC and IVC tumor thrombus (Mayo level 1-3) who underwent robotic surgery by a single surgeon (January 2023-January 2026). Preoperative computed tomography urography (CTU) images were used to generate 3D reconstruction models, enabling detailed visualization of tumor-vessel relationships and quantitative measurement of tumor parameters. The primary oncological endpoint was recurrence-free survival (RFS); overall survival (OS) was also evaluated as a secondary endpoint. Postoperative complications were graded using Clavien-Dindo (≥III defined as major), and renal function was assessed by eGFR. A two-sided p value < 0.05 was considered significant.
RESULTS: Among 71 patients, those with preoperative 3D reconstruction (n = 27) versus without (n = 44) showed significantly shorter postoperative hospital stay (8.0 vs 10.0 days, P = 0.04) and higher postoperative estimated glomerular filtration rate (eGFR) (76.0 vs 60.0, P = 0.01). Other perioperative benefits (blood transfusion, major complications) were not statistically significant. RFS and OS did not differ significantly between groups.
CONCLUSIONS: Preoperative 3D reconstruction helps facilitate RARN and IVC thrombectomy and improves perioperative outcomes. This technique holds promise for broader application in complex urological surgery.