Effects of PCNL under the guidance of hologram technology on stress response and renal injury factors in patients with complex kidney stones

PCNL with Hologram Tech: Impact on Kidney Stone Patients

  • Changming Liu
  • Zimin Dong
  • Mingxiong Sheng
  • Xinghua Huang
  • Youfeng Huang Mindong Hospital Affiliated to Fujian Medical University
Keywords: Holographic image technology, Complex kidney stones, Percutaneous nephrolithotripsy, Stress response, Kidney injury factor, Kidney function, Inflammatory response, complication

Abstract


Background: To investigate the effect of percutaneous nephrolithotomy (PCNL) guided by holographic image technology on stress response and renal injury factors in patients with complex renal calculi.

Methods: A retrospective analysis was conducted on the clinical data of 70 patients admitted to our hospital between August 2022 and June 2023 who had complex kidney stones. The patients were divided into two groups, namely, group A and group B, based on whether they received guidance from preoperative holographic imaging technology. Group A consisted of forty patients who underwent PCNL after undergoing renal CT examination prior to surgery, while Group B included thirty patients who underwent PCNL guided by holographic imaging technology. Various indexes, including operative factors, stress response, inflammatory response, renal injury factors, renal function, complication rate, and the rate of achieving complete stone clearance in a single procedure, were compared between the two groups.

Results: In group B, the puncture time and operation time of the target calyces were shorter compared to group A, additionally, the intraoperative blood loss in group B was lower than that in group A (P<0.05). 24 h after surgery, group B exhibited higher levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) compared to group A, additionally, the level of malondialdehyde (MDA) in group B was lower than that in group A (P<0.05). 24 h after surgery, group B exhibited lower levels of tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), IL-1, and hypersensitive C-reactive protein (hs-CRP) compared to group A (P<0.05). Furthermore, group B showed lower levels of neutrophil gelatinase-associated lipid carrier protein (NGAL), inducible protein-8-like molecule 2 (TIPE2), and β2-microglobulin (β2-MG) than group A at the 7-day mark (P<0.05). 24 h after the operation, There was no statistically significant difference observed in the levels of SCr, BUN, between group A and group Bgroup B(P > 0.05); however, exhibited lower levels of CysC compared to group A (P < 0.05). Additionally, there were no significant differences in postoperative complications between group B and group A (P>0.05). Furthermore, one month after surgery, the one-time stone clearance rate in group B was significantly higher than that in group A (P<0.05).

Conclusion: PCNL under the guidance of hologram technology can shorten the time of puncture target calyce and operation, reduce the amount of intraoperative blood loss, effectively reduce the postoperative stress reaction and inflammatory reaction of patients, reduce the level of renal injury factors, improve renal function, and increase the one-time stone clearance rate.

References

1. Tundo G, Vollstedt A, Meeks W, Pais V. Beyond Prevalence: Annual Cumulative Incidence of Kidney Stones in the United States. J Urology 2021; 205(6): 1704-9.
2. Zhang J, Xiao N, Huang K, Xu F, Pan G, Bo G. Effect of percutaneous nephrolithotripsy under guidance of B-ultrasound for the treatment of complex renal calculi. J Pak Med Assoc 2022; 72(6): 1198-200.
3. Sahan A, Cubuk A, Ozkaptan O, Ertas K, Toprak T, Eryildirim B, et al. How does puncture modality affect the risk of intraoperative bleeding during percutaneous nephrolithotomy? A prospective randomized trial. Actas Urol Esp (Engl Ed) 2021; 45(7): 486-92.
4. Gallioli A, De Lorenzis E, Boeri L, Delor M, Zanetti SP, Longo F, et al. Clinical utility of computed tomography Hounsfield characterization for percutaneous nephrolithotomy: a cross-sectional study. Bmc Urol 2017; 17(1): 104.
5. Ng FC, Yam WL, Lim T, Teo JK, Ng KK, Lim SK. Ultrasound-guided percutaneous nephrolithotomy: Advantages and limitations. Investig Clin Urol 2017; 58(5): 346-52.
6. Rogers MP, DeSantis AJ, Janjua H, Barry TM, Kuo PC. The future surgical training paradigm: Virtual reality and machine learning in surgical education. Surgery 2021; 169(5): 1250-2.
7. Desai J, Shah HN. Mini Percutaneous Kidney Stone Removal: Applicable Technologies. Urol Clin N Am 2022; 49(1): 161-73.
8. Ganpule AP, Naveen KRM, Sudharsan SB, Shah SB, Sabnis RB, Desai MR. Multitract percutaneous nephrolithotomy in staghorn calculus. Asian J Urol 2020; 7(2): 94-101.
9. Diri A, Diri B. Management of staghorn renal stones. Renal Failure 2018; 40(1): 357-62.
10. Klein I, Gutierrez-Aceves J. Preoperative imaging in staghorn calculi, planning and decision making in management of staghorn calculi. Asian J Urol 2020; 7(2): 87-93.
11. Kubihal V, Razik A, Sharma S, Das CJ. Unveiling the confusion in renal fusion anomalies: role of imaging. Abdom Radiol 2021; 46(9): 4254-65.
12. Checcucci E, Amparore D, Fiori C, Manfredi M, Ivano M, Di Dio M, et al. 3D imaging applications for robotic urologic surgery: an ESUT YAUWP review. World J Urol 2020; 38(4): 869-81.
13. Porpiglia F, Amparore D, Checcucci E, Autorino R, Manfredi M, Iannizzi G, et al. Current Use of Three-dimensional Model Technology in Urology: A Road Map for Personalised Surgical Planning. Eur Urol Focus 2018; 4(5): 652-6.
14. Checcucci E, Amparore D, Volpi G, Piramide F, De Cillis S, Piana A, et al. Percutaneous puncture during PCNL: new perspective for the future with virtual imaging guidance. World J Urol 2022; 40(3): 639-50.
15. Liu Z, Li X, Lu J. Application evaluation of mixed-reality holographic imaging technology in the surgical treatment of spinal cord glioma. Pak J Med Sci 2022; 38(7): 1958-63.
16. Ong R, Glisson CL, Burgner-Kahrs J, Simpson A, Danilchenko A, Lathrop R, et al. A novel method for texture-mapping conoscopic surfaces for minimally invasive image-guided kidney surgery. Int J Comput Ass Rad 2016; 11(8): 1515-26.
17. Wang F, Zhang C, Guo F, Ji J, Lyu J, Cao Z, et al. Navigation of Intelligent/Interactive Qualitative and Quantitative Analysis Three-Dimensional Reconstruction Technique in Laparoscopic or Robotic Assisted Partial Nephrectomy for Renal Hilar Tumors. J Endourol 2019; 33(8): 641-6.
18. Ukimura O, Nakamoto M, Gill IS. Three-dimensional reconstruction of renovascular-tumor anatomy to facilitate zero-ischemia partial nephrectomy. Eur Urol 2012; 61(1): 211-7.
19. Arsalani-Zadeh R, Ullah S, Khan S, MacFie J. Oxidative stress in laparoscopic versus open abdominal surgery: a systematic review. J Surg Res 2011; 169(1): e59-68.
20. Reuter S, Gupta SC, Chaturvedi MM, Aggarwal BB. Oxidative stress, inflammation, and cancer: how are they linked? Free Radical Bio Med 2010; 49(11): 1603-16.
21. Kohl BA, Deutschman CS. The inflammatory response to surgery and trauma. Curr Opin Crit Care 2006; 12(4): 325-32.
22. Wang L, Zhao Z, Wang G, Zhou J, Zhu H, Guo H, et al. Application of a three-dimensional visualization model in intraoperative guidance of percutaneous nephrolithotomy. Int J Urol 2022; 29(8): 838-44.
23. Antonelli A, Veccia A, Palumbo C, Peroni A, Mirabella G, Cozzoli A, et al. Holographic Reconstructions for Preoperative Planning before Partial Nephrectomy: A Head-to-Head Comparison with Standard CT Scan. Urol Int 2019; 102(2): 212-7.
24. Zeng G, Zhong W, Pearle M, Choong S, Chew B, Skolarikos A, et al. European Association of Urology Section of Urolithiasis and International Alliance of Urolithiasis Joint Consensus on Percutaneous Nephrolithotomy. Eur Urol Focus 2022; 8(2): 588-97.
25. Zhang K, Wang L, Sun Y, Wang W, Hao S, Li H, et al. Combination of holographic imaging with robotic partial nephrectomy for renal hilar tumor treatment. Int Urol Nephrol 2022; 54(8): 1837-44.
Published
2024/02/09
Section
Original paper