Utilization of three-dimensional renal tumor target vessel reconstruction and localization technology for Zero-Ischemia Laparoscopic Partial Nephrectomy: A Clinical Perspective

Objectives: To evaluate the safety and efficacy of utilizing three-dimensional renal tumor target vessel reconstruction to guide zero-ischemia laparoscopic partial nephrectomy. Methods: We conducted a retrospective review of data from 80 patients who were treated between January 2016 and September 2022. The patients were categorized into two groups based on the mode of operation. We compared the operation time, intraoperative blood loss, and postoperative hospital stay between the two groups. Results: In comparison to the traditional operation group, the zero ischemia group exhibited a longer operation time [(92.5±9.8) min vs. (71.6±9.9) min, P<0.001] and a higher volume of intraoperative blood loss[(152 ±22) ml vs. (80 ±19) mL, P<0.001], although there was no significant difference in postoperative hospital stay. Patients with renal hilar tumors experienced longer operation times [(109.3±10.2) min vs. (87.3±9.5) min, P<0.001] compared to those with tumors in other areas. There was no significant difference in intraoperative blood loss or hospital stay duration. Throughout the follow-up period, both groups did not experience complications such as bleeding, urine leakage, or tumor recurrence and metastasis. Three months post-operation, patients in the zero ischemia group demonstrated a faster recovery of glomerular filtration rate (GFR) compared to those in the traditional operation group, although there was no significant difference in serum creatinine level (P>0.05). Conclusion: In certain cases of early renal cell carcinoma, the utilization of three-dimensional renal tumor target vessel reconstruction and localization technology can significantly enhance the feasibility of laparoscopic zero ischemia nephron sparing surgery.