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Use 3D printing technology to enhance stone free rate in single tract percutaneous nephrolithotomy for the treatment of staghorn stones

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Abstract

This study assesses the feasibility and effectiveness of using a three-dimensional (3D) printing model for preoperative planning in the treatment of full staghorn stones, specifically in the selection of the most optimal calyx for puncture. Twelve patients were enrolled in this trial. A preoperative CT taken in prone position was performed on each of the patients. 3D models were reconstructed using digital imaging and 3D printers. Three identical models were printed for each patient. Three puncture sites from the upper-, middle-, and lower-pole calyces of the kidney models were selected for simulation of percutaneous nephrolithotomy. The stone-free rates were recorded after each of the simulations. The puncture site that yielded the maximum SFR was translated to the patient for the actual procedure. CT was performed postoperatively on both patients and simulation models. The SFR of patients and simulation models was compared. Correlation analysis and consistency analysis suggested that there was a high degree of consistency between patients and 3D-printed models. The Pearson product-moment correlation coefficient r for the postoperative stone volume of the patients (PoSVP) and postoperative stone volume of the models (PoSVM) was 0.972 (P < 0.001, 95% CI = 0.900–0.992). The Bland–Altman plot of PoSVP to PoSVM showed an icon of 95% consistency 205.8(− 725.5 ~ 1137.1), and 100% of the points were within the 95% limits of agreement. 3D-printed models can potentially be used for preoperative planning in the treatment of full staghorn stones, especially in the selection of the most optimal calyx for puncture.

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Funding

This research was funded by Science and Technology Planning Project of Guangdong Province, Grant no [2017B030314108] and Natural Science Foundation of Guangdong Province, Grant no [2018A030313087].

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Author notes

  1. Yuyu Xu, Yaoji Yuan and Yichuan Cai contributed equally to this work as the co-first authors.

Authors and Affiliations

  1. Department of Urology, The Fifth Affiliated Hospital of Guangzhou Medical University, No 621, Gangwan Road, Huangpu District, Guangzhou, 510700, Guangdong, China

    Yuyu Xu, Yaoji Yuan, Xun Li & Guibin Xu

  2. Department of Urology, Chaouzhou Central Hospital, No. 84, Huancheng West Road, Chaozhou, 521000, Guangdong, China

    Yichuan Cai

  3. Chinese-American Urology Stone Center, First People’s Hospital of Xiaoshan, No. 1099, Xinnan Road, Xiaoshan District, Hangzhou, 311200, China

    Shawpong Wan

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  1. Yuyu Xu
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  2. Yaoji Yuan
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  3. Yichuan Cai
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  4. Xun Li
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  5. Shawpong Wan
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  6. Guibin Xu
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Correspondence to Guibin Xu.

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Xu, Y., Yuan, Y., Cai, Y. et al. Use 3D printing technology to enhance stone free rate in single tract percutaneous nephrolithotomy for the treatment of staghorn stones. Urolithiasis 48, 509–516 (2020). https://doi.org/10.1007/s00240-019-01164-8

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  • DOI: https://doi.org/10.1007/s00240-019-01164-8

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