Application of image overlapping in percutaneous nephrolithotomy.

Area of Science:

• Urology
• Medical Imaging
• Surgical Technology

Background:

• Percutaneous nephrolithotomy (PCNL) is a key procedure for complex kidney stones.
• Optimizing puncture accuracy is crucial for PCNL success and minimizing complications.

Purpose of the Study:

• To evaluate the efficacy of combining ultrasound and CT image overlap for guiding percutaneous nephrolithotomy (PCNL).

Main Methods:

• 140 patients with complicated kidney stones were randomized into a research group (ultrasound and CT image overlap) and a control group (standard CT/ultrasound guidance).
• Preoperative 3D CT reconstruction and simulated puncture were used in the research group to determine the optimal puncture path.
• Surgical outcomes, including stone clearance, puncture success, and procedure time, were compared between groups.

Main Results:

• The research group demonstrated a higher stage I stone clearance rate, improved one-time puncture success, fewer percutaneous channels, and reduced hemoglobin reduction compared to the control group.
• Procedure time was significantly shorter in the research group.
• Complications in stage I PCNL and final stone clearance rates were comparable between the two groups.

Conclusions:

• Ultrasound and CT image overlap facilitate precise puncture selection for PCNL.
• This technique improves imaging-anatomy coincidence, reduces blood loss, shortens procedure time, and enhances the initial stone clearance rate in PCNL.