The role of three-dimensional reconstruction in partial nephrectomy for ipsilateral multifocal renal tumors: a multicenter retrospective study

This study aims to evaluate the clinical impact of three-dimensional (3D) reconstruction in partial nephrectomy for ipsilateral multifocal renal tumors (MIRTs), focusing on surgical precision, ischemia management, and postoperative outcomes. A retrospective analysis was performed on 56 MIRTs patients who underwent PN at two hospitals. Patients were divided into two groups: Group A (33 patients) received standard preoperative CT scans, while Group B (23 patients) underwent 3D reconstruction. Surgical data, including operative time, blood loss, ischemia time, and complications, were compared. Renal function was assessed using serum creatinine and eGFR levels preoperatively and postoperatively. Baseline demographics, including age, body mass index, preoperative hemoglobin levels, and tumor characteristics (size, multifocality), showed no significant intergroup differences (p > 0.05). The 3D reconstruction group demonstrated a 2.2 days reduction in hospital stay (9.43 vs. 11.63 days, p = 0.025) and achieved 100% adherence to preoperative surgical plans (vs. 81.9% in the 2D group, p = 0.037). Operative metrics, including operative time, estimated blood loss, ischemia time, and rates of collecting system injury, showed no significant differences (p > 0.05). Safety outcomes, such as conversion to radical nephrectomy (13.0% vs. 21.2%) and transfusion rates (8.6% vs. 9.1%), were comparable (p > 0.05). Postoperative renal function preservation, assessed by ΔeGFR and ΔSCr, also revealed no intergroup disparities (p > 0.05). Three-dimensional reconstruction technology enhances surgical precision and adherence to preoperative plans. It can be considered as a transformative tool in nephron-sparing surgery due to its potential to redefine standards for managing multifocal renal tumors.