实时通道长度在上皮肤性利切除术期间比手术前成像更短:对手术规划的影响
Ziv Savin1, Raghav Gupta, Shrinkhala Kaphle1
1Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Journal of endourology
|February 6, 2026
概括
精确估计nephrostomy管道的长度对于卧式皮肤透神经切除术 (PCNL) 是至关重要的. 术前CT扫描高估了通道长度,但新的公式提高了规划PCNL程序的准确性.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 放射学 放射学是一门学科.
- 手术规划 手术规划
背景情况:
- 精确估计nephrostomy管道的长度对于规划穿皮瘤切除术 (PCNL) 访问和仪器的准确估计至关重要.
- 仅有有限的数据可用于精确估计卧式PCNL的通道长度.
- 术前计算机断层扫描 (CT) 估计通常使用,但可能缺乏准确性.
研究的目的:
- 为了比较实时内科手术内瘤管道的长度与手术前CT-based估计在卧床PCNL.
- 评估一种新的CT-解剖学技术和STONEE的准确性. 石测量技术 - - 石测量技术.
- 开发一个预测模型,以更准确地估计手术内通道长度.
主要方法:
- 对患者进行卧式PCNL的前性研究.
- 使用手术前的CT扫描来估计CT-anatomical和S.T.O.N.E.通道长度. 技术. 技术. 技术. 这是一个很好的方法.
- 实时的手术内测量被盲目比较到基于CT的估计,使用统计分析 (Wilcoxon签名等级测试,MSE,ICC).
主要成果:
- 这两种基于CT的方法都显著高估了手术内通道的长度 (CT-解剖学:11.2厘米,STONE). : 11.4厘米与手术内:9厘米).
- 与S.T.O.N.E.相比,CT-解剖学方法与手术内值 (MSE = 10.42,ICC = 0.42) 有更好的一致性. (MSE=11.18,ICC=0.35) 这样一来,我们就会得到更多的机会.
- 结合患者和成像因素的多变量线性模型开发了一个准确的预测计算器 (MSE = 3.64,ICC = 0.58).
结论:
- 在手术前基于CT的通道长度估计往往高估了卧卧PCNL的实际手术内长度.
- 卧卧的位置可能会导致真正的通道长度比以前假设的要短.
- 一种新开发的预测公式显著提高了卧式PCNL规划的术前准确性.
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