دورية أكاديمية
Three-dimensional reconstruction and intraoperative ultrasonography: Crucial tools to safely approach highly complex renal masses
| العنوان: | Three-dimensional reconstruction and intraoperative ultrasonography: Crucial tools to safely approach highly complex renal masses |
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| المؤلفون: | Antonio Andrea Grosso, Luca Lambertini, Fabrizio Di Maida, Maria Lucia Gallo, Andrea Mari, Andrea Minervini |
| المصدر: | International Brazilian Journal of Urology, Vol 48, Iss 6, Pp 996-997 (2022) |
| بيانات النشر: | Sociedade Brasileira de Urologia, 2022. |
| سنة النشر: | 2022 |
| المجموعة: | LCC:Diseases of the genitourinary system. Urology |
| مصطلحات موضوعية: | Diseases of the genitourinary system. Urology, RC870-923 |
| الوصف: | ABSTRACT Purpose: Robot-assisted partial nephrectomy (RAPN) is rapidly increasing its role in the nephron-sparing surgery setting (1). The recent introduction of technological advancements is leading more experienced surgeons to approach complex renal mass with a conservative intent (2, 3). In particular, three-dimensional reconstruction and the use of intraoperative ultrasonography are gaining attention as crucial tools to safely and effectively approach complex cases (4, 5). We aimed to video-report the management of highly complex renal mass treated with RAPN, focusing on preoperative surgical planning and intraoperative technical nuances. Materials and methods: A 73-year-old male patient was referred to our institution for an incidental detection of a 70 mm diameter, completely endophytic, hilar renal mass (PADUA score 13, RENAL score 11a). Contrast-enhanced CT scan images were processed by M3DICS (Turin, Italy) and used to obtain a 3D virtual model. RAPN was performed by a highly experienced surgeon using Da Vinci Si robotic platform with a three-arm configuration. Results: The overall operative time was 114 min, with a warm ischemia time of 16 min. No intraoperative or postoperative complications were recorded. According to the SIB score, the pure enucleation excision strategy was performed. Histopathological analysis revealed a pT3a low-grade oncocytic kidney tumor with negative surgical margins. with negative surgical margins. At 24-months follow up, no local or systemic recurrence was detected. Conclusions: Conservative management of complex renal masses is challenging with a highly nuanced decision-making process. In this regard, preoperative 3D models and intraoperative ultrasound (US) guidance play a pivotal role to develop a tailored surgical strategy according to patient’ and tumor's characteristics. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 1677-6119 1677-5538 |
| Relation: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382022000600996&tlng=en; https://doaj.org/toc/1677-6119 |
| DOI: | 10.1590/s1677-5538.ibju.2022.0224 |
| URL الوصول: | https://doaj.org/article/8926e279e7874d7499d5509b12399fe2 |
| رقم الأكسشن: | edsdoj.8926e279e7874d7499d5509b12399fe2 |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 16776119 16775538 |
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| DOI: | 10.1590/s1677-5538.ibju.2022.0224 |