关键词: 3D可视化重建, 腹腔镜剜除术, 肾错构瘤, 肝肾功能, 创伤应激

Abstract: Objective To explore the influence of laparoscopic enucleation based on 3D visualization reconstruction on surgical blood loss, liver-kidney function and traumatic stress in patients with renal angiomyolipoma. Methods The clinical data of patients with renal angiomyolipoma admitted to the hospital from January 2020 to January 2025 were retrospectively analyzed. 42 patients with renal angiomyolipoma who received conventional laparoscopic surgery were included in control group, and 40 patients with renal angiomyolipoma who underwent laparoscopic enucleation based on 3D visualization reconstruction were included in study group. The surgery-related indexes and occurrence of postoperative complications were compared between the two groups, and the liver function indexes [alanine aminotransferase （ALT）, aspartate aminotransferase （AST）], renal function indexes [serum creatinine （SCr）, glomerular filtration rate （eGFR）] and serum traumatic stress indexes [total antioxidant capacity （TAC）, serum ischemia modified albumin （IMA）, myoglobin （MYO）] were evaluated in the two groups of patients before surgery and at 24 hours after surgery. Results The surgical time and hospitalization time in study group were significantly shortened compared with than those in control group （all P<0.05）. There were no statistical differences in the renal artery clamping time and blood loss during surgery between the two groups （all P>0.05）. At 24 hours after surgery, serum ALT, AST, SCr, IMA and MYO in the two groups were higher than those before surgery, and the levels of serum SCr, IMA and MYO in study group were lower than those in control group （all P<0.05）. However, there were no statistical differences in serum ALT and AST between study group and control group （P>0.05）. The eGFR and TAC in the two groups were lower than those before surgery, and the eGFR and TAC were higher in study group than those in control group （all P<0.05）. There was no statistical significance in the incidence of postoperative complications between the two groups （P>0.05）. Conclusion Laparoscopic enucleation under 3D visualization reconstruction is helpful to relieve the renal injury and traumatic stress response caused by surgery in patients with renal angiomyolipoma, and has a positive effect on shortening the surgical time and hospitalization time. As an auxiliary surgical technique, 3D visualization reconstruction technology has promotion value.

Key words: 3D visualization reconstruction, laparoscopic enucleation, renal angiomyolipoma, liver-kidney function, traumatic stress