[1]赖锦源 卢凯鑫 刘昌毅 何彦峰 陈文炜 张华 高锐**.肾脏incool3D立体影像技术在复杂肾结石经皮肾镜碎石取石术中的应用：前瞻性随机对照研究[J].中国微创外科杂志,2021,01(9):776-781.
　Lai Jinyuan,Lu Kaixin,Liu Changyi,et al.Application of Incool3D Stereoscopic Imaging Technique in Percutaneous Nephrolithotomy for Patients With Complicated Renal Stones: a Prospective Randomized Controlled Study[J].Chinese Journal of Minimally Invasive Surgery,2021,01(9):776-781.
点击复制

肾脏incool3D立体影像技术在复杂肾结石经皮肾镜碎石取石术中的应用：前瞻性随机对照研究()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2021年9期
页码:
776-781
栏目:
临床论著
出版日期:
2021-09-25

文章信息/Info

Title:
Application of Incool3D Stereoscopic Imaging Technique in Percutaneous Nephrolithotomy for Patients With Complicated Renal Stones: a Prospective Randomized Controlled Study
作者:
赖锦源 卢凯鑫 刘昌毅 何彦峰 陈文炜 张华 高锐**
（福建医科大学附属第一医院泌尿外科，福州350005）
Author(s):
Lai Jinyuan;  Lu Kaixin;  Liu Changyi;  et al.
Department of Urology, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
关键词:
3D立体影像; 复杂性肾结石; 经皮肾镜碎石取石术
Keywords:
3D stereoscopic imaging; Complicated renal stones; Percutaneous nephrolithotomy
文献标志码:
A
摘要:
目的探讨incool3D立体影像技术在复杂肾结石经皮肾镜碎石取石术前规划和术中的应用价值。方法选取我院2018年6月~2019年12月复杂性肾结石36例，随机分为incool3D立体影像组和对照组各18例，incool3D立体影像组依据3D立体影像图像和视频进行术前规划和术中应用，对照组依据术前KUB和CTU进行术前规划和术中应用。比较2组PCNL手术前预估和实际术中穿刺点和穿刺目标肾盏的吻合度、穿刺目标肾盏时间、手术时间、结石清除率、术后出血量、术后感染、引流管拔除时间和住院时间。结果incool3D立体影像的建立可以显示肾脏集合系统的三维立体结构、肾脏的血管分布情况以及肾结石与周围毗邻的关系。incool3D立体影像组术前谈话的各项评分均显著高于对照组（P<0.05）。incool3D立体影像组术前预估和实际术中穿刺点及穿刺目标肾盏的吻合度分别为88.9%（16/18）和94.4%（17/18），明显高于对照组55.6%（10/18）和61.1%（11/18）（Fisher精确检验，P=0.020，P=0.030）；incool3D立体影像组术中穿刺目标肾盏时间、手术时间和清石率分别为（3.8±1.5）、（92.3±6.1）min和94.4%（17/18），对照组分别为（6.1±1.1）、（99.1±6.3）min和66.7%（12/18），差异有统计学意义（t=5.311，P=0.000；t=3.284，P=0.002；Fisher精确检验，P=0.044）。2组术后出血、术后感染发生率、引流管拔除时间和住院时间差异无统计学意义（P>0.05）。结论incool3D立体影像能清楚显示肾脏的三维立体结构以及结石与周围毗邻的关系，可加强医患交流，提高手术效率，可在复杂性肾结石PCNL术中推广应用。
Abstract:
ObjectiveTo investigate the application value of incool3D stereoscopic imaging technique in percutaneous nephrolithotomy (PCNL) for patients with complicated renal stones.MethodsA total of 36 patients with complicated renal stones who underwent PCNL in our hospital between June 2018 and December 2019 were randomly divided into two groups (incool3D stereoscopic imaging technique group and control group) with 18 cases in each group. The incool3D stereoscopic imaging technique group underwent preoperative planning and intraoperative application according to 3D stereoscopic images and videos, and the control group underwent preoperative planning and intraoperative application according to preoperative KUB and computed tomography urography. The data of two groups in intraoperation and postoperation (consistence of target calyces between preoperatived designed puncture and introperative actual puncture, time of puncturing the target calyces, operation time, stone clearance rate, blood loss, postoperative infection, drainage tube removal time, hospitalization time) were compared.ResultsIncool3D imgaes clearly showed 3D renal collecting system, renal blood vessels and stones. The scores of questionnaries in the incool3D group were better than those in the control group (P<0.05). Consistence of puncture point and target calyces in the incool3D group between preoperatively designed puncture and intraoperative actual puncture was 88.9% (16/18) and 94.4% (17/18), which were significantly higher than 55.6% (10/18) and 61.1% (11/18) in the control group (Fisher’s exact test, P=0.020, P=0.030). Time of puncturing the target calcyce, operation time and stone clearance rate in the incool3D group were (3.8±1.5) min, (92.3±6.1) min, and 94.4% (17/18), respectively, and they were higher than those ［(6.1±1.1) min, (99.1±6.3) min, and 66.7%(12/18)］ in the control group (t=5311, P=0.000; t=3.284, P=0.002; Fisher’s exact test, P=0.044). There were no statistical significances in blood loss, postoperative infection, drainage tube removal time and hospitalization time between the two groups (P>0.05).ConclusionIncool3D images can clearly show the relationship between 3D renal collecting system and complicated renal stones, enhance the compliance of patients, and improve the accuracy and safety of PCNL for complicated renal stones.

参考文献/References:

[1]Diri A, Diri B. Management of staghorn renal stones. Ren Fail,2018,40(1):375-362.
[2]Xiao B, Diao XL, Hu WG, et al. Influence of the anatomy of the collecting system upon percutaneous nephrolithotomy for removal of renal staghorn stones. Chin Med J(Engl),2018,131(14):1759-1760.
[3]Chen MY, Skewes J, Desselle M, et al. Current applications of threedimensional printing in urology. BJU Int,2020,125(1):17-27.
[4]Cacciamani GE, Okhunov Z, Meneses AD, et al. Impact of threedimensional printing in urology: state of the art and future perspectives: a systematic review by ESUTYAUWP Group. Eur Urol,2019,76(2):209-221.
[5]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(5):652-656.
[6]zgür BC, Ayyldz A. 3D printing in urology: Is it really promising Turk J Urol,2018,44(1):6-9.
[7]魏晓松,刘征,庄乾元,等.3D打印技术在经皮肾镜取石术术前规划及医患沟通中的应用研究.中华泌尿外科杂志,2015,36(12):881-885.
[8]黄健,王建业,孔垂泽,等.主编.2019版中国泌尿外科和男科疾病诊断和治疗指南.第1版.北京:科学出版社,2019.52-53.
[9]曾国华, 李逊,主编.经皮肾镜取石术.第1版.北京: 人民卫生出版社,2011.201,212-217.
[10]齐勇,翁国斌,汤春波,等.斜仰截石位多镜联合一期治疗复杂性肾结石.中国微创外科杂志,2017,17(1):59-61.
[11]Alsawi M, Amer T, Mariappan M, et al. Conservative management of staghorn stones. Ann R Coll Surg Engl,2020,102(4):243-247.
[12]Huang Q, Zeng Z. A review on realtime 3D ultrasound imaging technology. Biomed Med Res Int,2017,26(3):1-20.
[13]Lima E, Rodrigues PL, Mota P, et al. Ureteroscopyassisted percutaneous kidney access made easy: first clinical experience with a novel navigation system using electromagnetic guidance (IDEAL Stage 1). Eur Urol,2017,72(4):610-616.
[14]Soliman Y, Feibus AH, Baum N. 3D printing and its urologic applications. Rev Urol,2015,17(1):20-24.
[15]Youssef RF, Spradling K, Yoon R, et al. Applications of threedimensional printing technology in urological practice. BJU Int,2015,116(5):697-702.
[16]曹健,朱帅,叶明佶,等.3D打印技术辅助腹腔镜下肾肿瘤冷冻消融术.中国微创外科杂志,2018,18(12):1118-1120.
[17]Wake N, Bjurlin MA, Rostami P, et al. Threedimensional printing and augmented reality: enhanced precision for robotic assisted partial nephrectomy. Urology,2018,116(6):227-228.
[18]刘宇保,刘彬,胡卫国,等.3D打印技术对鹿角形肾结石PCNL术前精准设计的临床研究.临床泌尿外科,2018,33(1):30-35.

备注/Memo

备注/Memo:
基金项目：福建省医学创新课题（2017-CX-26）**通讯作者，Email：fyyyruigao@163.com
更新日期/Last Update: 2021-12-09