Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Department of Burn and Plastic Surgery, General Hospital of Northern Theater Command, Shenyang, Liaoning, China.
Department of Burn and Plastic Surgery, General Hospital of Northern Theater Command, Shenyang, Liaoning, China.
Urology. 2023 Jun;176:219-225. doi: 10.1016/j.urology.2022.12.067. Epub 2023 Mar 14.
To evaluate the clinical value of mixed reality-assisted puncture navigation (MRAPN) in percutaneous nephrolithotripsy (PCNL).
Two hundred patients undergoing PCN were enrolled, all of whom had kidney stones to be subjected to lithotripsy by PCNL and grouped according to surgical procedure into the MRAPN (n = 100) and non-mixed reality-assisted puncture (non-MRAPN) (n = 100) groups. CT data in DICOM format for all patients in the MRAPN group were imported into 3D reconstruction and mixed reality (MR) post-processing workstations, and holographic 3D visualization modelling. Comparing parameters such as the operative time (OT), puncture time (PT), number of attempts, and estimated blood loss (EBL), a Likert scale was used to assess the clinical value of MRAPN. The Cohen κ coefficient (k) was employed to evaluate consistency among assessors; safety was assessed.
There were no significant differences in patient demographic indicators or preoperative general information between the MRAPN and non-MRAPN groups (P > .05). The clinical value of MRAPN was higher for subjective scores regarding surgical planning, intraoperative navigation, didactic guidance and physician-patient communication (all P < .001). The PT was significantly shorter in the MRAPN group (P < .001), with a shorter overall OT and lower EBL (P < .001). There were no significant differences in the overall comparison, length of hospital stay, or preoperative or postoperative creatinine (all P > .05).
MRAPN can safely and effectively improve the success of PCN, reduce complications, and decrease the PT, OT, and EBL.
评估混合现实辅助穿刺导航（MRAPN）在经皮肾镜碎石取石术（PCNL）中的临床价值。
共纳入 200 例行 PCNL 的患者，所有患者均有肾结石，需接受 PCNL 碎石治疗，并根据手术方式分为混合现实辅助穿刺（MRAPN）组（n=100）和非混合现实辅助穿刺（non-MRAPN）组（n=100）。将 MRAPN 组所有患者的 DICOM 格式 CT 数据导入 3D 重建和混合现实（MR）后处理工作站，进行全息 3D 可视化建模。比较两组的手术时间（OT）、穿刺时间（PT）、穿刺次数和估计失血量（EBL）等参数，采用 Likert 量表评估 MRAPN 的临床价值。采用 Cohen κ 系数（k）评估评估者之间的一致性；评估安全性。
MRAPN 组和 non-MRAPN 组患者的人口统计学指标或术前一般资料比较差异无统计学意义（P＞0.05）。在手术规划、术中导航、教学指导和医患沟通方面，MRAPN 的主观评分均较高（均 P＜0.001）。MRAPN 组的 PT 明显缩短（P＜0.001），OT 总时长和 EBL 降低（均 P＜0.001）。两组在总比较、住院时间、术前和术后肌酐方面比较差异无统计学意义（均 P＞0.05）。
MRAPN 可安全有效地提高 PCNL 成功率，减少并发症，缩短 PT、OT 和 EBL。
