Three-Dimensional Virtual Reconstruction Method versus Standard Fluoroscopy as a Guiding Tool for an Optimal Puncture Rout in Patients Undergoing Percutaneous Nephrolithotomy: A Randomized Trial Study
Urology Journal,
Vol. 21 No. 01 (2024),
28 February 2024
,
Page 29-34
https://doi.org/10.22037/uj.v20i.7459
Abstract
Purpose: Three-Dimensional (3D) could help for planning and creating an optimal access route in percutaneous nephrolithotomy (PCNL) procedure by achieving a more accurate approach to the renal collecting system and stone treatment while decreasing the risk of complications. The aim of our study is to compare the efficacy of 3D imaging technique with standard fluoroscopy method as a guiding tool for renal stone location while striving to reduce intra-operative X-ray exposure in the former method.
Materials and Methods: This randomised clinical trial enrolled 48 PCNL candidates who were referred to Sina Hospital (Tehran, Iran). Participants were divided into two equal groups of intervention (3D virtual reconstruction) and control, using block randomization method. Age, sex, stone type and location, X-ray exposure during the procedure, stone access accuracy rate and the necessity of blood transfusion during surgery were taken into account.
Results: The Mean age of participants (n = 48) was 46.4 ± 4.8 years, 34 (70.8%) were male, 27 (56.3%) had partial staghorn stones and all participants had stones within the lower calyx. The radiation exposure time, stone access time and stone size were 2.99 ± 1.81 seconds, 272.3 ± 108.9 seconds and 23.06 ± 2.28 mm, respectively. In the intervention group, the accuracy rate for lower calyceal stone access was 91.5%. Also, X-ray exposure and time to stone access were significantly lower in the intervention group compared to the controls (P < 0.001).
Conclusion: We concluded that the utilization of 3D technology in the pre-operative location of renal calculi in PCNL candidates may result in a significant improvement in the accuracy and time to access the renal calculi, as well as reduction in X-ray exposure.
- 3-Dimensional (3D) technology, Percutaneous Nephrolithotomy, Renal stone.
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References
Khan A. Prevalence, pathophysiological mechanisms and factors affecting urolithiasis. Int Urol Nephrol.2018; 50:799-806.
Lieske JC, Rule AD, Krambeck AE, et al. Stone composition as a function of age and sex. Clin J Am Soc Nephrol. 2014; 9:2141-6.
Bahmani M, Baharvand-Ahmadi B, et al. Identification of medicinal plants for the treatment of kidney and urinary stones. J Renal Inj Prev. 2016; 5:129-33.
Miller NL, Lingeman JE.Management of kidney stones. BMJ.2007;334:468-72.
de la Rosette JJ, Opondo D, Daels FP, et al. Categorisation of complications and validation of the Clavien score for percutaneous nephrolithotomy. Eur Urol. 2012; 62:246-55.
Autorino R, Porpiglia F, Dasgupta P. Precision surgery and genitourinary cancers. Eur J Surg Oncol. 2017; 43:893-908.
Porpiglia F, Amparore D, Checcucci E, et al.Current Use of Three-dimensional Model Technology in Urology: A Road Map for Personalised Surgical Planning. Eur Urol Focus. 2018;4:652-6.
Rassweiler-Seyfried MC, Rassweiler JJ, Weiss C, et al. iPad-assisted percutaneous nephrolithotomy (PCNL): a matched pair analysis compared to standard PCNL. World J Urol. 2020;38:447-53.
Porpiglia F, Bertolo R, Checcucci E, et al. Development and validation of 3D printed virtual models for robot-assisted radical prostatectomy and partial nephrectomy: urologists' and patients' perception. World J Urol.2018; 36:201-7.
Shin T, Ukimura O, Gill IS. Three-dimensional Printed Model of Prostate Anatomy and Targeted Biopsy-proven Index Tumor to Facilitate Nerve-sparing Prostatectomy. Eur Urol.2016; 69:377-9.
Zhang Y, Ge HW, Li NC, et al.Evaluation of three-dimensional printing for laparoscopic partial nephrectomy of renal tumors: a preliminary report. World J Urol.2016; 34:533-7.
Klein JT, Rassweiler J, Rassweiler-Seyfried MC. Validation of a Novel Cost Effective Easy to Produce and Durable In Vitro Model for Kidney-Puncture and Percutaneous Nephrolitholapaxy-Simulation. J Endourol.2018; 32:871-6.
Lee LC, Violette PD, Tailly T, et al. A comparison of outcomes after percutaneous nephrolithotomy in children and adults: a matched cohort study. J Pediatr Urol.2015; 11:250.1-6.
Christiansen AR, Shorti RM, Smith CD, Prows WC, Bishoff JT. Intraoperative utilization of advanced imaging modalities in a complex kidney stone case: a pilot case study. World J Urol.2018; 36:733–43.
Tan H, Xie Y, Zhang X, et al. Assessment of Three-Dimensional Reconstruction in Percutaneous Nephrolithotomy for Complex Renal Calculi Treatment. Front Surg. 2021;8:701207.
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