Value of integrating three-dimensional technology with the Sampaio collecting system fractal theory for percutaneous nephrolithotomy treatment of difficult renal calculi

Abstract

Abstract Objective To investigate the safety and efficacy of percutaneous nephrolithotomy (PCNL) in the treatment of complicated renal calculi by integrating three-dimensional (3D) computed tomography (CT) reconstruction with the Sampaio collecting system fractal theory. Methods Sixty-four consecutive patients with complex kidney calculi who underwent PCNL between January 2019 and October 2023 were retrospectively analyzed and divided into an experimental group (3D printing) and control group (CT imaging) according to their willingness to pay for 3D imaging. Both groups underwent preoperative CT urography. The Digital Imaging and Communications in Medicine data of the experimental group from CT imaging were used for 3D reconstruction and model printing. Then, the Sampaio collecting system fractal theory was used to design the puncture channel and develop a surgical strategy. Results The 3D-printed models of the experimental group successfully displayed the Sampaio collecting system fractal theory. There was no significant difference in the baseline parameters between the groups. Compared with the control group, the experimental group exhibited significant improvements in the puncture time, number of puncture needles, number of puncture channels, target calyx consistency, number of first puncture channels, and stone clearance. There were no significant differences in the total operative time, decrease in the hemoglobin level, length of hospital stay, and postoperative complications between the groups. Conclusions Integration of 3D technology with the Sampaio collecting system fractal theory can enhance the preoperative evaluation and planning of percutaneous renal access. This approach allows a more precise method of PCNL for treating intricate renal calculi.