Impact of 3D Reconstruction and Printing on Surgical Outcomes in Renal Tumour Surgery.

Abstract

Background and purpose: With the advances in imaging technology that have enabled the widespread adoption of nephron-sparing surgical techniques, the incidence of renal tumours has concurrently risen. Current guidelines recommend partial nephrectomy for all tumours smaller than 7 cm and, when feasible, even for larger lesions. However, the increasing use of nephron-sparing surgery and advancements in imaging have highlighted the substantial variability in renal hilar anatomy, which poses challenges during surgical procedures. Three-dimensional (3D) imaging technology integrated into preoperative planning has been proposed as a complement to conventional radiological studies to address this complexity. This study aims to evaluate the impact of preoperative 3D imaging and printing on the surgical management of renal cancer.

Methods: A prospective cohort study was conducted involving 37 patients managed according to standard clinical protocols. The patients were divided into two groups: One group underwent preoperative 3D tumour reconstruction and printing, and the other did not. Key surgical outcomes, including operative time, intraoperative blood loss, need for transfusion and status of surgical margins on pathological examination, were assessed. All 3D models were reconstructed and printed using polylactic acid (PLA) by the same urologist to ensure consistency.

Results: The group that received preoperative 3D reconstruction demonstrated remarkable reductions in intraoperative blood loss and operative time, with no cases of positive surgical margins. No significant differences in tumour size, renal nephrometry index or surgery performed were observed between the two groups.

Conclusions: The incorporation of 3D printing and reconstruction into the surgical planning of renal tumours offers tangible benefits, including reduced intraoperative blood loss, short operative duration and enhanced oncological outcomes by minimising the risk of positive margins. These findings support the potential of 3D technology as a valuable adjunct to traditional preoperative assessment in oncological renal surgery.