Clinical efficacy of membrane anatomy-based 3D laparoscopic partial nephrectomy in a single stage for the treatment of ruptured renal angiomyolipoma.

OBJECTIVE

This study aims to describe the preliminary single-center clinical experience with membrane anatomy-based 3D laparoscopic partial nephrectomy (LPN) performed in a single stage for selected patients with ruptured renal angiomyolipoma (RAML), and to assess its perioperative feasibility and short-term outcomes.

METHODS

A single-center retrospective descriptive design was employed to collect clinical data from 12 patients with ruptured renal angiomyolipoma who were treated between January 2020 and December 2025. All patients underwent 3D LPN via a transabdominal approach, with strict adherence to membrane anatomy principles during surgery.

RESULTS

A total of 12 patients underwent 3D laparoscopic surgery for ruptured renal angiomyolipoma. All patients successfully completed the procedure without conversion to open surgery, and none required radical nephrectomy. The average surgical duration was 311.83 ± 85.46 minutes, with a mean warm ischemia time of 25.5 ± 11.02 minutes. Intraoperative blood loss averaged 327.00 ± 114.00 mL, and 83.33% of patients required intraoperative blood transfusions. Pain levels progressively decreased after surgery, with average VAS scores of 4.00 ± 1.00 at 24 hours and 3.20 ± 0.84 at 48 hours. Renal function markers showed transient fluctuations. The preoperative mean serum creatinine was 78.44 ± 23.97 μmol/L, which increased to 90.68 ± 28.07 μmol/L postoperatively, and then decreased to 85.55 ± 22.84 μmol/L at the 3-month follow-up. No tumor recurrence was observed during the postoperative follow-up period.

CONCLUSION

Membrane anatomy-based 3D LPN for selected ruptured RAML cases showed acceptable perioperative safety, renal function preservation, and postoperative recovery, but requires validation in larger prospective comparative studies.