Application value of three-dimensional visualization imaging technology in laparoscopic partial nephrectomy for complex renal tumors

Abstract

Objective: To evaluate three-dimensional visualization (3DV) imaging technology in laparoscopic partial nephrectomy (LPN) for complex renal tumors.

Methodology: In this prospective study conducted at Heji Hospital Affiliated to Changzhi Medical College and First Hospital of Shanxi Medical University between March 2018 and June 2025, 247 patients with complex renal tumors (RENAL score 7-9) were randomized to 3DV preoperative planning group (Group-A, n=123) or conventional 2D imaging group (Group-B, n=124). All underwent retroperitoneal LPN. Group-A received 3D models from enhanced CT for planning and intraoperative navigation. Outcomes included warm ischemia time (WIT), operation time, hemoglobin drop, hospital stay, complications, postoperative rehabilitation, and long-term follow-up.

Results: Group-A vs. Group-B: WIT 20.81±0.94 vs. 27.72±0.82 min (P=0.001); operation time 148.17±5.86 vs. 151.72±5.56 min (P<0.001); hemoglobin drop 10.19±1.00 vs. 16.32±1.41 g/L (P=0.001); hospital stay 6.98±0.15 vs. 11.06±0.86 d (P<0.001). Urinary fistula: 0 vs. 1 case. Analgesic use: 15.6±4.2 vs. 24.3±5.8 mg (P=0.003); ambulation: 22.4±3.6 vs. 34.7±5.1 h (P<0.001); flatus: 28.1±4.0 vs. 41.3±6.2 h (P<0.001). Median follow-up 38 months. Recurrence: 3.3% vs. 4.8% (P=0.54). No difference in creatinine rise (P=0.834).

Conclusion: 3DV imaging technology improves LPN precision and safety for complex renal tumors, shortening WIT, reducing bleeding, speeding recovery, and preserving renal function.