Zhang Jiamo, Qing Jing, Hu Ke, Cheng Honglin
Department of Urology, Yangchuan Hospital, Chongqing Medical University, Chongqing, China.
Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Surg. 2024 Oct 22;11:1471958. doi: 10.3389/fsurg.2024.1471958. eCollection 2024.
To investigate the safety and efficacy of percutaneous nephrolithotomy (PCNL) in the treatment of complicated renal calculi by integrating three-dimensional (3D) computed tomography (CT) reconstruction with the Sampaio classification of the renal collecting system.
Sixty-four consecutive patients with complex kidney calculi who underwent PCNL between January 2019 and October 2023 were retrospectively analyzed and divided into experimental group (3D printing) and control group (CT imaging) according to their willingness to pay for 3D imaging. Both groups underwent preoperative CT urography. The Digital Imaging and Communications (DICOM) in Medicine data of the experimental group from CT imaging were used for 3D reconstruction and model printing. Then, the Sampaio classification system was used to design the puncture channel and develop a surgical strategy.
The 3D-printed models of the experimental group successfully displayed the Sampaio classification system. There was no significant difference in the baseline parameters between the groups. Compared with the control group, the experimental group exhibited significant improvements in the puncture time, number of puncture needles, number of puncture channels, target calyx consistency, number of first puncture channels, and stone clearance. There were no significant differences in the total operative time, decrease in the hemoglobin level, length of hospital stay, and postoperative complications between the groups.
Integration of 3D technology with the Sampaio classification of the renal collecting system can enhance the preoperative evaluation and planning of percutaneous renal access. This approach allows a more precise method of PCNL for treating complex renal calculi.
通过将三维(3D)计算机断层扫描(CT)重建与肾集合系统的桑帕约分类相结合,研究经皮肾镜取石术(PCNL)治疗复杂性肾结石的安全性和有效性。
回顾性分析2019年1月至2023年10月期间连续接受PCNL治疗的64例复杂性肾结石患者,并根据其对3D成像的付费意愿分为实验组(3D打印)和对照组(CT成像)。两组均接受术前CT尿路造影。实验组CT成像的医学数字成像和通信(DICOM)数据用于3D重建和模型打印。然后,使用桑帕约分类系统设计穿刺通道并制定手术策略。
实验组的3D打印模型成功显示了桑帕约分类系统。两组间基线参数无显著差异。与对照组相比,实验组在穿刺时间、穿刺针数量、穿刺通道数量、目标肾盏一致性、首次穿刺通道数量和结石清除率方面有显著改善。两组间总手术时间、血红蛋白水平下降、住院时间和术后并发症无显著差异。
3D技术与肾集合系统的桑帕约分类相结合可加强经皮肾穿刺术前评估和规划。这种方法为治疗复杂性肾结石提供了更精确的PCNL方法。