Prediction of Intraoperative Urinary Collecting System Entry in Patients with Peripheral Renal Tumors Undergoing Partial Nephrectomy: Usefulness of Tumor-Centered Multiplanar Reconstruction.

Abstract:

OBJECTIVE:To assess the usefulness of tumor-centered multiplanar reconstruction (TC-MPR) for predicting intraoperative urinary collecting system (UCS) entry in patients with peripheral renal tumors undergoing partial nephrectomy (PN). METHODS:Dynamic computed tomography images of 50 peripheral cT1 renal tumors treated with laparoendoscopic PN were analyzed. TC-MPR generated a digital cross-sectional image showing the tumor center and the closest calyx on a same plane. Patients and tumor characteristics including the distance from the tumor margin to the closest calyx (MPR-distance), and the angle formed by 2 tangent lines from the closest calyx to the tumor (MPR-angle) were assessed. RESULTS:Intraoperative UCS entry was observed in 15 patients (30%). The patients who experienced intraoperative UCS entry had a higher RENAL score, wider MPR-angle, and shorter MPR-distance than those who did not (p = 0.04, p = 0.001, p < 0.001, respectively). Multivariate analysis identified MPR-angle as an independent factor for intraoperative UCS entry (p < 0.001). CONCLUSIONS:The spatial information assessed using TC-MPR serves as a predictive factor for intraoperative UCS entry during PN.

journal_name

Urol Int

journal_title

Urologia internationalis

authors

Uehara S,Yoshida S,Tanaka H,Yasuda Y,Tanaka H,Kijima T,Yokoyama M,Ishioka J,Matsuoka Y,Saito K,Fujii Y

doi

10.1159/000484254

subject

Has Abstract

pub_date

2018-01-01 00:00:00

pages

85-91

issue

1

eissn

0042-1138

issn

1423-0399

pii

000484254

journal_volume

100

pub_type

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