The application of CT 3D reconstruction for percutaneous nephrolithotomy in treating staghorn Calculi

Abstract

Objective A lot of problems have been encountered in percutaneous nephrolithotomy in treatment of staghorn calculi, 3D CT reconstruction technique could construct the real staghorn calculi and kidney 3D image, which help us in the operations to make sure the best percutaneous renal channel, and improve the success rate of puncture by B-ultrasound localization. Methods Twenty-five patients with staghorn calculi who underwent urinary CT scan and 3D reconstruction were enrolled into CT reconstruction group. Through 3D rotation display, we designed the shortest distance channel, which directed to renal pelvis, with the most widely and convenient operating angle. Thirty patients only underwent urinary CT scan, and designed the operating channel with multiplanar CT film, who were enrolled into CT group. All of them underwent 16 F channel PCNL procedures in lateral semisupine lithotomy position, treated by nephroscope Holmium laser lithotripsy. While we discussed 2 typical cases of staghorn calculi cases. Results There were statistical significances in blood loss [(108±24) ml vs (156±45) ml], operative time [(109±20) min vs (121±23) min], stone-free rate (91.21% vs 85.73%), blood transfusion (0 vs 6.67%), and massive hemorrhage post-operative cured by selective embolism of renal artery(0 vs 6.67%) between the two groups. Besides, there were no differences in the nephrostomy tube remaining time [(6.5±1.9) d vs (7.7±1.7) d] and hospital stay duration [(13.0±1.8) d vs (14.5±3.0) d]. Conclusions 3D CT reconstruction technique could construct the real staghorn calculi and kidney 3D image, which provided a more accurate percutaneous renal channel, it's safe and effective for PCNL. Key words: CT reconstruction; Renal; Percutaneous nephrolithotomy