1. Prediction of Intraoperative Urinary Collecting System Entry in Patients with Peripheral Renal Tumors Undergoing Partial Nephrectomy: Usefulness of Tumor-Centered Multiplanar Reconstruction
- Author
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Sho Uehara, Hiroshi Tanaka, Yoh Matsuoka, Junichiro Ishioka, Toshiki Kijima, Soichiro Yoshida, Hajime Tanaka, Yasuhisa Fujii, Minato Yokoyama, Kazutaka Saito, and Yosuke Yasuda
- Subjects
Male ,medicine.medical_specialty ,Urology ,Urinary system ,medicine.medical_treatment ,030232 urology & nephrology ,Collection system ,Nephrectomy ,Kidney Calices ,Calyx ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,medicine ,Humans ,In patient ,Intraoperative Complications ,Aged ,Retrospective Studies ,business.industry ,Kidney Neoplasm ,Middle Aged ,Multiplanar reconstruction ,Kidney Neoplasms ,Peripheral ,Surgery ,030220 oncology & carcinogenesis ,Female ,Radiology ,Tomography, X-Ray Computed ,business - 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.
- Published
- 2017
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