Efficacy and safety of 3D printing-assisted percutaneous nephrolithotomy in complex renal calculi

Abstract

This study evaluated the efficacy and safety of 3D printing technology combined with percutaneous nephrolithotomy in the treatment of complex renal calculi. Ninety patients with complex renal calculi were randomly divided into a 3D printing group (45 patients) and a control group (45 patients). In the 3D printing group, a patient-specific 1:1 3D printing model was established based on the patient's thin-layer CT scanning data. A 3D printing model was used for preoperative communication between doctors and patients. Preoperative puncture training, channel design, residual stone prediction, and percutaneous nephrolithotomy were performed under the guidance of a 3D printing model and B-ultrasound. The control group was treated with the conventional B-ultrasound-guided puncture method. Results suggest that there was a statistically significant difference between the two groups (P < 0.05). The overall score of the doctor-patient communication objects in the 3D printing group was 19.32 ± 1.57 points, and in the control group, it was 14.51 ± 2.13 points. The operation time of the 3D printing group was 103.21 ± 13.49 min, and that of the control group was 126.12 ± 25.87 min. The calculi clearance rate of the 3D printing group was 96%, while that of the control group was 80%. The incidence of postoperative complications was 6.67% in the 3D printing group and 22.22% in the control group. Compared with traditional percutaneous nephrolithotomy, 3D printing technology combined with percutaneous nephrolithotomy can significantly enhance the effectiveness of doctor–patient communication, shorten operation time, reduce operation bleeding, improve the stone clearance rate, reduce the incidence of complications and shorten the length of hospital stay. The proposed method is thus a safe and effective method to treat complex renal calculi.

Advances in percutaneous renal puncture: a comprehensive review of the literature

“…It is worth mentioning that the communication between surgeon and patient was ameliorated, as the model provides the capability for better interpretation of the disease and the complexity of the operation. The 3D printing model group was significantly superior concerning the plan-operation coincidence rate (97.78 vs. 78.78%, P < 0.01), the mean puncture time (7.21 vs. 9.73 min, P < 0.01) and the mean operation time (103.21 vs. 126.12, P < 0.01), with significantly improved outcomes also concerning SFR, haemoglobin loss, LOS and complication rates [35]. In another pilot study by Keyu et al [36], 3D puncture guide plates were printed based on preoperative CT urography with patients in the prone position.…”

“…The new type of printers upgraded the contribution of the 3D technology to PCNL. Cui et al [35] evaluated the application of physical (printed) 3D models in the preoperative puncture plan, even for complex cases (sponge or horseshoe kidneys), comparing 48 3D patients with 45 conventional USG patients. It is worth mentioning that the communication between surgeon and patient was ameliorated, as the model provides the capability for better interpretation of the disease and the complexity of the operation.…”

Percutaneous nephroscopy combined with the laser used for right kidney bullet extraction: A case report

“…Especially, 3D modeling technology makes the whole localization progress more intuitive, accurate and reliable, providing a highly feasible modelized technique of localization. [ 5 ] During the operation, a precise puncture guided by ultrasound directly reached the bullet. The combined application of CT and ultrasonic localization can effectively reduce the possibility of the injury of renal parenchyma and renal vessels during operation, which is of great significance to control or even eradicate blood loss and ensure a clear vision.…”

Pediatric Urolithiasis: Current Surgical Strategies and Future Perspectives

“…Not only 3D-CT reconstructions but also 3D printing technologies have been used to plan PCNL in case of complex renal calculi. In 2022, Cui et al ( 33 ) run a randomized controlled trial to investigate the efficacy and the safety of 3D printing combined with PCNL for the treatment of kidney stones. The 3D printed model of the urinary tract was used to communicate with patients and help them to fully understand the indications for surgery and the surgical approach needed, the expected results, the surgical risks, and the possible post-operative complications.…”