The effect of calculus model made by preoperative 3D printing technique on the puncture accuracy and postoperative complications of percutaneous nephrolithotomy

Abstract

Objective To investigate the effect of calculus model made by preoperative 3D printing technique on the puncture accuracy and postoperative complications of percutaneous nephrolithotomy (PCNL). Methods Thirteen patients with kidney calculi who underwent PCNL in our hospital between June 2014 and August 2016 were selected as study subjects, and all patients underwent ultrasound and 64 slice spiral CT examination before operation. The DICOM formatted files of CT were processed by the 3D medical image data processing platform. The thermoplastic plastics were used for 3D print, and the 3D kidney calculus models were obtained. 3D stone kidney model was obtained and simulated puncture in vitro. Analysis the function of 3D model of PCNL instructed to establish percutaneous renal access.The operation time, intraoperative blood loss, stone clearance rate, postoperative hospital stay and postoperative complications were observed. Results The 3D calculus models of 13 patients were successfully printed, There were no significant differences in the renal length, transverse diameterand the longest diameter [(11.89±0.46) cm, (6.87±0.25) cm, (4.10±0.27) cm] under 3D models and the the actual values (P>0.05). The accuracy of 3D model guided PCNL was 100%, and there was no significant differences between the estimated puncture depth [(5.76±0.65) cm] and the actual puncture depth [(6.14±0.34) cm, P>0.05]. The total score of the 3D model was (30.13±1.55), and the scores of patients and their family members on the 3D models was (31.45±0.99). Operation time(55±24) min, and intraoperative blood loss was(62.2±12.7)mL, postoperative hospitalization was(5.5±1.2)d. There were no complications such as peripheral organ injury, bleeding and infection in 13 patients. Conclusions The 3D printing models can better reflect the relationship between the stones and the surrounding tissues, guide the accurate puncture of PCNL and communication between doctors and patients, and reduce postoperative complications, which is worthy of clinical application. Key words: Kidney Calculi; Nephrostomy, Percutaneous; Postoperative Complications