1 research outputs found
Renal Volume Loss During Partial Nephrectomy Due to Resected Healthy Parenchyma: A Tool for Quick Estimation
Purpose: Our objective is to evaluate a technique for estimating the amount of healthy margin resected during partial nephrectomy (PN).
Materials and Methods: The resected healthy margin volume was determined by planimetry (gold standard), which was performed in a prospective manner on 30 freshly resected renal masses by cross-sectional slicing every βΌ5βmm. A single cross-sectional slice containing the largest tumor diameter (bivalved tumor) was chosen to build a model for estimating the amount of healthy kidney removed. This single-slice technique was then applied to a second series of patients (nβ=β39) status post PN. Three-dimensional models were created using pre- and postoperative CT scans to determine the overall volume loss following PN.
Results: The median (range) for tumor diameter and tumor volume was 3.2βcm (1β6.1) and 10.7βcm3 (0.5β101.9), respectively, for the 30 PN specimens used to build the single-slice estimation equation. The median (range) healthy margin volume calculated by planimetry and single slice technique was 9.0βcm3 (1.0β22.1) and 7.8βcm3 (1.0β31.0), respectively (pβ=β0.37). The Pearson correlation was 0.84, and the median (range) percent difference between the planimetry and single slice techniques was β0.5% (β39% to 57%). For the 39 PN patients, the median (range) total renal volume loss, 25.8βcm3 (3β79), was significantly greater than the volume of healthy margin removed during resection, 5.7βcm3 (1β22), pβ<β0.001.
Conclusions: The healthy margin resected during PN differs widely and can be estimated from a single cross-section. The healthy margin resected accounted for <50% of the total volume loss seen during PN