Department for Pediatric Surgery, Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands.
Technical Medicine, TechMed Centre, University of Twente, 7522 NB Enschede, The Netherlands.
Curr Oncol. 2022 Feb 1;29(2):777-784. doi: 10.3390/curroncol29020066.
Nephron-sparing surgery (NSS) in Wilms tumor (WT) patients is a surgically challenging procedure used in highly selective cases only. Virtual resections can be used for preoperative planning of NSS to estimate the remnant renal volume (RRV) and to virtually mimic radical tumor resection. In this single-center evaluation study, virtual resection for NSS planning and the user experience were evaluated. Virtual resection was performed in nine WT patient cases by two pediatric surgeons and one pediatric urologist. Pre- and postoperative MRI scans were used for 3D visualization. The virtual RRV was acquired after performing virtual resection and a questionnaire was used to assess the ease of use. The actual RRV was derived from the postoperative 3D visualization and compared with the derived virtual RRV. Virtual resection resulted in virtual RRVs that matched nearly perfectly with the actual RRVs. According to the questionnaire, virtual resection appeared to be straightforward and was not considered to be difficult. This study demonstrated the potential of virtual resection as a new planning tool to estimate the RRV after NSS in WT patients. Future research should further evaluate the clinical relevance of virtual resection by relating it to surgical outcome.
保留肾单位手术（NSS）在 Wilms 肿瘤（WT）患者中是一种具有挑战性的手术，仅在高度选择的病例中使用。虚拟切除术可用于 NSS 的术前规划，以估计残余肾体积（RRV）并模拟根治性肿瘤切除术。在这项单中心评估研究中，评估了 NSS 规划的虚拟切除术和用户体验。由两名儿科外科医生和一名小儿泌尿科医生对九名 WT 患者病例进行了虚拟切除术。使用术前和术后 MRI 扫描进行 3D 可视化。在进行虚拟切除后获得虚拟 RRV，并使用问卷评估易用性。实际的 RRV 源自术后 3D 可视化，并与推导的虚拟 RRV 进行比较。虚拟切除术得出的虚拟 RRV 与实际 RRV 几乎完全匹配。根据问卷调查，虚拟切除术似乎很直接，并不被认为困难。这项研究表明，虚拟切除术作为一种新的规划工具，在 WT 患者的 NSS 后估计 RRV 具有潜力。未来的研究应通过将其与手术结果相关联，进一步评估虚拟切除术的临床相关性。
