Pd01-06 novel intraoperative navigation using ultra-high-resolution ct in robot-assisted partial nephrectomy

You have accessJournal of UrologyCME1 Apr 2023PD01-06 NOVEL INTRAOPERATIVE NAVIGATION USING ULTRA-HIGH-RESOLUTION CT IN ROBOT-ASSISTED PARTIAL NEPHRECTOMY Kiyoshi Takahara, Kenji Zennami, Takuhisa Nukaya, Masashi Takenaka, Manabu Ichino, Hitomi Sasaki, Mamoru Kusaka, Makoto Sumitomo, and Ryoichi Shiroki Kiyoshi TakaharaKiyoshi Takahara More articles by this author , Kenji ZennamiKenji Zennami More articles by this author , Takuhisa NukayaTakuhisa Nukaya More articles by this author , Masashi TakenakaMasashi Takenaka More articles by this author , Manabu IchinoManabu Ichino More articles by this author , Hitomi SasakiHitomi Sasaki More articles by this author , Mamoru KusakaMamoru Kusaka More articles by this author , Makoto SumitomoMakoto Sumitomo More articles by this author , and Ryoichi ShirokiRyoichi Shiroki More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003218.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Successful surgery in robot-assisted partial nephrectomy (RAPN), especially for highly complex tumors, relies on a detailed understanding of the anatomical relations of the tumor absolute and relative to the urinary tract and the vascular structures, including the renal pedicle. Intraoperative navigation with accurate information regarding tumor position relative to the surrounding urinary vascular structures undoubtedly assists the surgeon during RAPN. METHODS: We retrospectively analyzed 323 patients who underwent RAPN using an ultra-high-resolution computed tomography (UHR-CT) scanner or area-detector CT (ADCT) to assess the perioperative and short-term functional outcomes of RAPN with intraoperative navigation using a UHR-CT scanner. Perioperative outcomes and the postoperative preservation ratio of estimated glomerular filtration rate (eGFR) were compared. RESULTS: 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). CONCLUSIONS: 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. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e65 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kiyoshi Takahara More articles by this author Kenji Zennami More articles by this author Takuhisa Nukaya More articles by this author Masashi Takenaka More articles by this author Manabu Ichino More articles by this author Hitomi Sasaki More articles by this author Mamoru Kusaka More articles by this author Makoto Sumitomo More articles by this author Ryoichi Shiroki More articles by this author Expand All Advertisement PDF downloadLoading ...