Three-Dimensional Virtual Reconstruction Method versus Standard Fluoroscopy as a Guiding Tool for an Optimal Puncture...

Area of Science:

• Urology
• Medical Imaging
• Surgical Planning

Background:

• Percutaneous nephrolithotomy (PCNL) is a key procedure for kidney stone removal.
• Accurate pre-operative planning is crucial for PCNL success and complication reduction.
• Standard fluoroscopy may have limitations in precise renal collecting system access.

Purpose of the Study:

• To compare the efficacy of 3D imaging versus standard fluoroscopy for guiding renal stone location in PCNL.
• To evaluate the potential of 3D technology to reduce intra-operative X-ray exposure.
• To assess the impact of 3D imaging on stone access accuracy and procedure time.

Main Methods:

• A randomized clinical trial involving 48 PCNL candidates.
• Participants were divided into two groups: 3D virtual reconstruction (intervention) and standard fluoroscopy (control).
• Key metrics included age, sex, stone characteristics, X-ray exposure, stone access accuracy, and transfusion necessity.

Main Results:

• The 3D imaging group demonstrated a 91.5% accuracy rate for lower calyceal stone access.
• Significantly lower X-ray exposure and time to stone access were observed in the 3D intervention group compared to controls (P < 0.001).
• Mean participant age was 46.4 ± 4.8 years, with 70.8% males.

Conclusions:

• 3D technology offers significant improvements in pre-operative renal calculus localization for PCNL.
• Utilization of 3D imaging enhances accuracy and reduces access time to renal calculi.
• 3D technology aids in minimizing intra-operative radiation exposure during PCNL procedures.