Clinical comparative analysis of 3D and 2D laparoscopic partial nephrectomy for renal tumors / 第二军医大学学报

ABSTRACT

Objective To compare the clinical efficacies of 3D and 2D laparoscopic partial nephrectomy for renal tumors and to investigate the pros and cons of 3D laparoscopic partial nephrectomy. Methods We retrospectively analyzed the clinical data of 134 patients with renal tumors; they underwent laparoscopic partial nephrectomy between Aug. 2013 and Mar. 2016 by the same surgical group in Changhai Hospital and Changzheng Hospital, Second Military Medical University. Fifty-three cases were included in the 3D laparoscopic partial nephrectomy group and 81 cases in the 2D laparoscopic partial nephrectomy group. The perioperative and follow-up data subjected to comparison and analysis included operative time, estimated blood loss, intraoperative transfusion, warm ischemic time, recovery time of bowel function, length of hospitalization, perioperative complications, and pre- and post-operative glomerular filtration rate (GFR). Results All operation procedures of this study were completed uneventfully without conversion to open surgery or radical nephrectomy, and surgical margins were negative in all cases. The operative time ([193.40±45.14] vs [217.00±59.19] min, P = 0.015), warm ischemic time ([23.70±6.96] vs [26.60±8.10] min, P = 0.032) and decrease of GFR of the operated kidney ([12.70 + 6.49] vs [15. 10 + 6. 45] mL • min-1 • 1. 73 m2, P = 0. 036) in the 3D group were significantly improved compared with those in the 2D group. However, the estimated blood loss, intraoperative transfusion, recovery time of bowtt function, length of hospitalization and perioperative complications were not significantly different between the two groups (P>0. 05). Att the patients with complications were discharged from the hospitat after conservative therapy. During a follow-up of 1-32 months, no patients had acute or chronic renat failure, local recurrence or distant metastasis, and there was no death case. Conclusion Compared with 2D laparoscopic partial nephrectomy, 3D laparoscopic technology can reduce operative time and warm ischemic time, which can help to better conserve renal function.