Work

Application of three-anatomical-plane dissection technique in the partial nephrectomy of renal cell carcinoma abutting the hilum gulf

Year: 2025

Type: article

Abstract: To describe the application of a three-anatomical-plane dissection (TAPD) technique for RCC-AHG and evaluate its feasibility and safety. Between June 2019 and October 2023, 42 patients undergoing PN using the TAPD technique at Ruijin Hospital were included. The data collected including patient demographic characteristics, oncological characteristics, perioperative and follow-up data on complications, renal function, recurrence and metastasis within 12 months after surgery. Patients underwent robotic or laparoscopic surgery by the transabdominal or retroperitoneal approach, depending on the tumor location. The three contact planes of the RCC-AHG tumor were anatomically dissected sequentially: the interface between the tumor and the perirenal fat (C1), the interface between the tumor and the renal hilum vessels (C2), and the interface between the tumor and the kidney parenchyma (C3). A total of 42 RCC-AHG patients were eventually enrolled. The median tumor diameter was 35.51 ± 13.99 cm; RENAL score: 9 (range: 8–11); no postoperative complications with Clavien–Dindo classification ≥ 2 (0.0%); no positive surgical margins (0.0%); the median differences of eGFR between the preoperative and 1 day, 3 months, 6 months and 12 months after surgery: -10.99 ± 15.49, -9.59(-18.02-0.75), -7.98(-17.41-1.53) and − 2.13(-9.94-2.76) mL/min/1.73 m 2 , respectively; and no recurrence or metastasis occurred at 12 months after surgery (0.00%). TAPD-based PN for RCC-AHG is safe and feasible and does not hinder renal function significantly. This technique may become a new surgical strategy for the treatment of RCC-AHG.

Source: World Journal of Surgical Oncology

DOI: 10.1186/s12957-025-04089-2