| Objective:To study the clinical application of Hisense computer-assisted surgery system(Hisense CAS)in percutaneous nephrolithotomy(PCNL).Using Hisense CAS to reconstruct the three-dimensional model of the CTU image of complex kidney stones and establish the virtual simulation operation channel to formulate the best surgical plan,which is used for PCNL assisted positioning and puncture and guide lithotripsy,so as to explore the effect of Hisense CAS on percutaneous The effect of nephrolithotomy on stone removal rate and safety.Methods : To study 32 patients with complicated kidney stones admitted to the Department of Urology,Qingdao University Hospital from October 2019 to October 2020,using computer assisted surgery(CAS)to import thin-layer enhanced CT imaging data Hisense CAS extracts relevant information,measures and analyzes the anatomical parameters of the kidneys and stones,and constructs a three-dimensional model,which assists in adding different colors to the kidney stones,renal collecting system,ureter,renal artery,renal vein,etc.,to make the spatial structure of the stone More intuitive and three-dimensional.According to the results of Hisense CAS three-dimensional reconstruction,preoperative planning for the establishment of the patient’s surgical puncture points and skin-renal passages,and formulating the surgical plan.It is used for PCNL’s auxiliary positioning to guide surgery and for preoperative communication and discussion to guide percutaneous nephrolithotomy(CAS-PCNL group).In the control group,68 patients who completed surgery only under the guidance of traditional CT images(PCNL group)during the same period were selected.Compare the stone removal rate,operation time,Hb loss,postoperative infection cases and postoperative hospital stay in the CAS-PCNL group and the PCNL group.Results : In this study,the 3D spatial model of 32 cases was successfully reconstructed through Hisense CAS three-dimensional reconstruction technology.The reconstructed model has a clear structure and can visually observe the spatial relationship between the internal structure of the kidney and the stone,as well as the kidney and the spine and the 11 th and 12 th ribs.The relationship between the two can clearly observe the shape of the renal arteries and veins;the renal calyx and renal pelvis have a clear structure.Of the 32 patients in the CAS-PCNL group,28 patients had stones removed at one time,4patients had residual stones,and the primary stone removal rate was 87.5%;in the PCNL group,44 patients had stones removed at one time,24 cases The patient had residual stones,and the first-stage stone clearance rate was 64.7%.Comparison of age,gender,BMI,diameter of stones,maximum cross-sectional area,CT value,expansion degree of collecting system,number of renal calyxes involved,anatomical abnormalities of glial calyx system,number of cutaneous renal channels,and channel size of the two groups of patients There is no statistical difference.As for the influencing factors of stone clearance rate,univariate Logistic regression analysis found that stone diameter,stone load,ST0.NE evaluation,and surgical method were statistically significant;and the inclusion of multivariate Logistic regression analysis found that stone diameter(OR=16.192,95 %CI(1.797-145.858),P=0.013),surgical method(OR=7.651,95%CI(1.866-31.364),P=0.005)were independent factors influencing stone removal rate.In the comparison of operation time,Hb loss,postoperative infection complications and postoperative hospital stay between the two groups,there was no statistical difference between the two groups(P>0.05).Conclusion:The application of the computer-assisted surgery system(Hisense CAS)in PCNL has a certain significance for improving the stone removal rate,and can provide higher resolution image information for disease evaluation,surgical plan formulation,postoperative residual stone prediction,etc.It is based,but there is no difference in the comparison of operation time,hemoglobin loss,postoperative infection and postoperative hospital stay. |
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