Objective:

To analyze and discuss the value of CAS 3D reconstruction in preoperative evaluation, surgical planning, and perioperative outcomes for pediatric hydronephrosis caused by ARA compression.

Approach:

• Study Design: Single-center retrospective observational comparative case series involving 263 children with UPJO-related hydronephrosis, identifying 20 patients with ARA compression.
• Group Allocation: Patients were divided into a 3D reconstruction group (n = 13) and a control group (n = 7) based on clinical complexity and surgeon preference.
• Data Collection: Preoperative imaging, medical records, and surgical documents were reviewed to compare preoperative diagnosis, operative time, intraoperative blood loss, length of hospital stay, and complications.

Key Findings:

• Conventional imaging failed to detect ARA compression preoperatively in all patients.
• CAS 3D reconstruction identified ARA compression in all 13 patients of the 3D group.
• Operative time was significantly shorter in the 3D group (108 min) compared to the control group (128 min, P = 0.002).
• Intraoperative blood loss was significantly lower in the 3D group (5 mL) compared to the control group (8 mL, P = 0.007).
• Length of hospital stay was comparable between both groups (9 days).

Interpretation:

CAS 3D reconstruction provided anatomical information for surgical planning and improved perioperative metrics in pediatric patients with ARA-related hydronephrosis.

Limitations:

• Single-center study may limit generalizability.
• Non-random group allocation could introduce bias.

Conclusion:

CAS 3D reconstruction effectively visualizes ARA compression preoperatively and is associated with improved surgical outcomes in pediatric hydronephrosis.