Clinical implications of 3D printing technology in preoperative evaluation of partial nephrectomy / 中南大学学报(医学版)

OBJECTIVES@#Renal cancer is a common malignancy of the urinary system, and the partial nephrectomy is a common surgical modality for early renal cancer. 3D printing technology can create a visual three-dimensional model by using 3D digital models of the patient's imaging data. With this model, surgeons can perform preoperative assessment to clarify the location, depth, and blood supply of the tumor, which helps to develop preoperative plans and achieve better surgical outcomes. In this study, the R.E.N.A.L scoring system was used to stratify patients with renal tumors and to explore the clinical application value of 3D printing technology in laparoscopic partial nephrectomy.@*METHODS@#A total of 114 renal cancer patients who received laparoscopic partial nephrectomy in Xiangya Hospital from June 2019 to December 2020 were enrolled. The patients were assigned into an experimental group (n=52) and a control group (n=62) according to whether 3D printing technology was performed, and the differences in perioperative parameters between the 2 groups were compared. Thirty-nine patients were assigned into a low-complexity group (4-6 points), 32 into a moderate-complexity group (7-9 points), and 43 into a high-complexity group (10-12 points) according to R.E.N.A.L score, and the differences in perioperative parameters between the experimental group and the control group in each score group were compared.@*RESULTS@#The experimental group had shorter operative time, renal ischemia time, and postoperative hospital stay (all P<0.05), less intraoperative blood loss (P=0.047), and smaller postoperative blood creatinine change (P=0.032) compared with the control group. In the low-complexity group, there were no statistically significant differences between the experimental group and the control group in operation time, renal ischemia time, intraoperative blood loss, postoperative blood creatinine changes, and postoperative hospital stay (all P>0.05). In the moderate- and high- complexity groups, the experimental group had shorter operative time, renal ischemia time, and postoperative hospital stay (P<0.05 or P<0.001), less intraoperative blood loss (P=0.022 and P<0.001, respectively), and smaller postoperative blood creatinine changes (P<0.05 and P<0.001, respectively) compared with the control group.@*CONCLUSIONS@#Compared with renal tumor patients with R.E.N.A.L score<7, renal cancer patients with R.E.N.A.L score≥7 may benefit more from 3D printing assessment before undergoing partial nephrectomy.

Diagnosis and treatment of renal oncocytoma of 6 cases and literature review / 中南大学学报(医学版)

To improve the diagnosis and treatment of renal oncocytoma and avoid unnecessary radical nephrectomy. The clinical data of 6 cases of renal oncocytoma diagnosed at the Second Xiangya Hospital Central South University from March 2005 to November 2010, including symptoms, laboratory tests, imaging, style of operation, pathological examination, and follow-up were retrospectively analyzed.There were no special symptoms and obvious abnormal laboratory tests in the patients. Two patients had relatively special imaging. Partial nephrectomy was performed in 2 cases of renal oncocytoma with typical imaging, while radical nephrectomy was performed on other patients because of misdiagnosis. No relapse and metastasis were found in the following 1 to 5 years.Renal oncocytoma is an uncommon benign tumor. Partial nephrectomy or tumor excision can be performed on patients diagnosed with renal oncocytoma according to typical imaging and intraoperative frozen section biopsy. The final diagnosis depends on pathological examination and regular follow-up is imperative for patients with renal oncocytoma.

Diagnosis and treatment of mature adrenal teratoma / 中南大学学报(医学版)

To discuss the pathology, clinical manifestation, diagnosis, therapy and prognosis of mature teratoma in adrenal gland. We reported 2 cases of mature adrenal teratoma and summarized their characters. No local recurrence or metastasis was found in the close follow-up of the 2 patients after the radical resection. Teratomas are rare germ tumors with potential malignant character which usually occur in the testes and ovaries. Adrenal teratomas are extremely rare and the diagnosis relies on radiological examinations. Early diagnosis and early surgical resection are the key in the treatment. Whether the postoperative chemotherapy is needed depends on the pathological result. Close lifelong follow-up is recommended and the prognosis is unclear at present.