title: Laparoscopic nephron-sparing surgery: preoperative assessment with three-dimensional computed tomography.
abstract: OBJECTIVE
  For retroperitoneal laparoscopic nephron-sparing surgery using a microwave tissue coagulator, it is helpful to know the relationship between the tumour, collecting system and vessels to prevent urinary leakage and vascular damage. We assessed the efficacy of multiplanar reformation and three-dimensional (3D) CT with the renal collecting system filled with contrast medium.
  
  
  METHODS
  Fifteen patients with small renal tumours of less than 3 cm in diameter underwent dynamic CT examination ten minutes after injection of contrast medium of 30 ml. Multiplanar reformation, volume-rendered and maximum intensity projection images were created for determining operative approaches and for planning the operation.
  
  
  RESULTS
  In all cases, the distance between the tumour and collecting system was measured on the multiplanar reformation. Accordingly, five cases were indicated for retroperitoneal laparoscopic nephron-sparing surgery using a microwave tissue coagulator. The remaining ten cases, due to the short distance (less than 10mm), were not considered good candidates for this procedure. The relationship between the tumour, collecting system and vessels was well shown on the volume-rendered and maximum intensity projection images.
  
  
  CONCLUSIONS
  Multiplanar reformation and 3D-CT are able to give us an understanding of the surrounding structures. They are helpful in defining the indications for retroperitoneal laparoscopic nephron-sparing surgery using a microwave tissue coagulator and preoperative planning of nephron-sparing surgery.
authors.affiliation: Department of Radiology, Graduate School of Biomedical Science, Hiroshima University, 1-2-3 Kasumi-cho, Minami-ku, Hiroshima 734-8551, Japan. k-maru@ra2.so-net.ne.jp
authors.forename: Kazushi
authors.initials: K
authors.lastname: Marukawa
authors.forename: Jun
authors.initials: J
authors.lastname: Horiguchi
authors.forename: Masanobu
authors.initials: M
authors.lastname: Shigeta
authors.forename: Yuji
authors.initials: Y
authors.lastname: Akiyama
authors.forename: Koji
authors.initials: K
authors.lastname: Mita
authors.forename: Tsuguru
authors.initials: T
authors.lastname: Usui
authors.forename: Koji
authors.initials: K
authors.lastname: Arihiro
authors.forename: Katsuhide
authors.initials: K
authors.lastname: Ito
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D014057:Tomography, X-Ray Computed