Application of simulated puncture in percutaneous nephrolithotomy

Area of Science:

• Urology
• Medical Imaging
• Surgical Technology

Background:

• Complex kidney stones pose challenges for percutaneous nephrolithotomy (PCNL).
• Accurate puncture is crucial for successful PCNL and minimizing complications.

Purpose of the Study:

• To evaluate the clinical utility of simulated puncture in PCNL for complex kidney stones.
• To compare PCNL outcomes with and without preoperative simulated puncture.

Main Methods:

• 120 patients with complex kidney stones underwent PCNL.
• The research group (n=60) had preoperative 3D reconstruction and simulated puncture using CT data.
• The control group (n=60) underwent standard PCNL without simulation.

Main Results:

• The simulated puncture group showed statistically significant improvements in shorter operation time, fewer punctures, and reduced blood loss (p < 0.05).
• Higher stone clearance and lower kidney injury incidence were observed in the simulation group, though not statistically significant.
• Successful first-stage PCNL was achieved in both groups.

Conclusions:

• Preoperative simulated puncture enhances puncture accuracy in PCNL for complex kidney stones.
• This technique is valuable for reducing procedure time, number of punctures, and intraoperative blood loss.
• Simulated puncture is a promising method for promoting better PCNL outcomes.