在混合手术室中进行圆束计算机断层扫描辅助的皮肤内切除术:优化患者选择
Riemer A Kingma1, Rianne Mors1, Mieke T J Bus1
1Department of Urology, University Medical Center Groningen, University of Groningen, the Netherlands, Groningen, Netherlands.
Journal of endourology
|February 29, 2024
概括
通过皮质神经结石切除术 (PCNL) 期间的手术内形圆束计算断层扫描 (CBCT) 有助于检测剩余的结石. 这种成像技术可以在37%的病例中进行额外的石头去除,改善PCNL的结果,特别是复杂的石头.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 医疗成像医学成像
背景情况:
- 穿皮石切除术 (PCNL) 是一种常见的石切除手术.
- 术内成像对于确保石头完全清除至关重要.
- 在PCNL之后的残留石块可能会导致并发症和重新治疗.
研究的目的:
- 在PCNL期间评估形束计算断层扫描 (CBCT) 的实用性.
- 评估CBCT对无石头率的影响以及需要额外的石头开采的需要.
- 通过CBCT指导,确定与成功的额外石头去除相关的因素.
主要方法:
- 在2018年至2021年期间,对102名接受PCNL治疗的患者进行了回顾性队列研究.
- 在最初的石头去除后,进行了手术内非对比CBCT扫描.
- 患者根据CBCT后的石头清除情况进行分类,并对残留碎片进行干预.
主要成果:
- 在57%的病例中,CBCT检测到残留化.
- 在38%的所有手术中 (61%的残留碎片病例) 进行了额外的石头提取.
- 较高的男人的石头得分与需要额外的石头提取的可能性增加有关.
结论:
- 在混合手术室内进行的手术内CBCT可以显著提高PCNL后的无结石率.
- 在很大一部分情况下,CBCT有助于额外的石头去除,特别是在复杂的石头负载中.
- 这项技术提高了PCNL的有效性,特别是在具有挑战性的手术场景中.
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