The Application Value of 3D Model in Partial Nephrectomy of Varying Complexity.

Introduction: The aim of the study was to explore the application value of three-dimensional (3D) model in partial nephrectomy across varying RENAL scores.

Methods: A total of 126 patients were enrolled, divided into three groups: 25 cases in the 3D-partial nephrectomy (3D-PN), 86 cases in the 2D-partial nephrectomy (2D-PN), and 15 cases in the 3D-robot-assisted PN (3D-RAPN). Preoperative basic data were collected, including age, gender, neutrophil ratio, platelet count, blood glucose, GFR of the kidney, tumor diameter, tumor staging, RENAL score, Mayo Adhesive Probability (MAP) score, surgical time, warm ischemia time, intraoperative bleeding, postoperative drainage volume, postoperative hospital stay, change in creatinine level at 3 months postoperatively, and pathological results. Perioperative data between 3D-PN and 2D-PN, between the RENAL score 4-6 subgroup of 3D-PN and 2D-PN, between the RENAL score ≥7 subgroup of 3D-PN and 2D-PN, and between the 3D-PN and 3D-RAPN were compared. Statistical analysis was performed using SPSS version 26.0.

Results: The 3D-PN showed statistically significant differences compared to the 2D-PN in warm ischemia time, intraoperative bleeding volume, postoperative drainage volume, and postoperative hospital stay (p < 0.05). In the RENAL score 4-6 subgroup, the 3D-PN showed statistically significant differences in intraoperative bleeding volume compared to the 2D-PN (p < 0.05). In the RENAL score ≥7 subgroup, the 3D-PN showed statistically significant differences compared to the 2D-PN in surgical time, warm ischemia time, postoperative drainage volume, and postoperative hospital stay (p < 0.05). There were statistically significant differences between the 3D-PN and the 3D-RAPN in warm ischemia time, intraoperative bleeding volume, and postoperative hospital stay (p < 0.05).

Conclusion: Patients with RENAL score ≥7 benefit more from preoperative evaluation with 3D model. The combination of 3D model and RARP can further enhance the advantages and expand the convenience of surgery.