Clinical Application Of Mixed Reality Three-dimensional Reconstruction Assisted ABC Scoring System In Minimally Invasive Partial Nephrectomy

Objective:The purpose of this study is to evaluate the clinical application effect of ABC Scoring System based on mixed reality three-dimensional reconstruction in minimally invasive partial nephrectomy(MIPN),to obtain better therapeutic effect.Methods:The patients who underwent Laparoscopic partial nephrectomy(LPN)in a3A hospital from January 2021 to December 2022 were analyzed retrospectively.Among them,the ABC scoring system aided LPN based on mixed reality three-dimensional reconstruction is the experimental group,and the ABC scoring system aided LPN based on CT images is the control group.There were 66 patients in the experimental group and 80 patients in the control group.The surgeons used ABC scoring system based on mixed reality three-dimensional reconstruction(experimental group)or CT images combined with ABC scoring system(control group)to make surgical plans.T-test,Mann-Whitney U-test orχ~2-test were used to observe and compare the clinical indexes such as operation time,ischemic time,estimated blood loss and short-term renal function after operation between the two groups.In addition,18 patients with ABC score≥2 in the experimental group were continuously selected.The three-dimensional reconstruction images of the above 18 patients were displayed to 22 urologists,and the simplicity of ABC scoring system and the feasibility of clinical application of three-dimensional reconstruction assisted ABC scoring system were investigated by questionnaire.In addition,in order to explore the clinical application effect of robot-assisted partial nephrectomy(RAPN)assisted by ABC scoring system based on mixed reality three-dimensional reconstruction.Under the condition of ABC scoring system based on mixed reality three-dimensional reconstruction,RAPN was performed on 9 patients with renal tumors.Results:Compared with the LPN assisted by ABC scoring system based on CT images,the operation time of the experimental group was shorter(151.97±48.16min vs 182.10±49.28min,P<0.01),and the median renal ischemia time was shorter(25.00(22.00,27.50)min vs 28.00(22.75,30.00)min,P=0.016),and the median estimated blood loss after operation was even less(100.00(50.00,150.00)ml vs100.00(50.00,200.00)ml,P=0.01).A total of 22 urologists completed the questionnaire survey(including five questions),and all doctors gave a good evaluation of the ABC scoring system based on mixed reality three-dimensional reconstruction to assist MIPN.Nine patients with renal tumor successfully completed RAPN with the help of ABC scoring system based on mixed reality three-dimensional reconstruction.The limitations of this study include that all patients come from a single institution,and the ability of ABC scoring system based on mixed reality three-dimensional reconstruction to predict complications and long-term renal function is not analyzed.Conclusion:ABC scoring system based on mixed reality three-dimensional reconstruction assisted LPN,which can shorten the operation time,ischemia time and reduce the amount of bleeding,is a safe and reliable auxiliary surgery technology.ABC scoring system is simple and easy to learn,but it has certain requirements for image data.With the help of mixed reality three-dimensional reconstruction,clinicians can not only score ABC more clearly,but also better apply it to MIPN.