Novel Intraoperative Navigation Using Ultra-High-Resolution CT in Robot-Assisted Partial Nephrectomy

Cancers

Yoshiharu Ohno¹  Ryo Matsukiyo¹  Hiroshi Toyama¹  Hitomi Sasaki²  Takuhisa Nukaya²  Kosuke Fukaya²  Manabu Ichino²  Kenji Zennami²  Ryoichi Shiroki²  Kiyoshi Takahara²  Makoto Sumitomo²  Masashi Takenaka²  Mamoru Kusaka³  Naohiko Fukami³ 

[1] Department of Radiology, Fujita-Health University School of Medicine, Nagoya 470–1192, Japan;Department of Urology, Fujita-Health University School of Medicine, Nagoya 470–1192, Japan;Department of Urology, Okazaki Medical Center, Fujita Health University, Okazaki 444–0827, Japan;

关键词: estimated blood loss;    robot-assisted partial nephrectomy;    ultra-high-resolution computed tomography;    warm ischemia time;   

DOI  :  10.3390/cancers14082047

来源: DOAJ

【 摘 要 】

To assess the perioperative and short-term functional outcomes of robot-assisted partial nephrectomy (RAPN) with intraoperative navigation using an ultra-high-resolution computed tomography (UHR-CT) scanner, we retrospectively analyzed 323 patients who underwent RAPN using an UHR-CT or area-detector CT (ADCT). Perioperative outcomes and the postoperative preservation ratio of estimated glomerular filtration rate (eGFR) were compared. After the propensity score matching, we evaluated 99 patients in each group. Although the median warm ischemia time (WIT) was less than 25 min in both groups, it was significantly shorter in the UHR-CT group than in the ADCT group (15 min vs. 17 min, p = 0.032). Moreover, the estimated blood loss (EBL) was significantly lower in the UHR-CT group than in the ADCT group (33 mL vs. 50 mL, p = 0.028). However, there were no significant intergroup differences in the postoperative preservation ratio of eGFR at 3 or 6 months of follow-up (ADCT 91.8% vs. UHR-CT 93.5%, p = 0.195; and ADCT 91.7% vs. UHR-CT 94.0%, p = 0.160, respectively). Although no differences in short-term renal function were observed in intraoperative navigation for RAPN in this propensity score–matched cohort, this study is the first to demonstrate that UHR-CT resulted in a shorter WIT and lower EBL than ADCT.

【 授权许可】

Unknown