Clinical Application And Teaching Value Of 3D Printed Model Assisted Ureteroscopy In The Treatment Of Residual Lithotripsy After Percutaneous Nephroscopy

Objective: To investigate the clinical effect of 3D printed model assisted ureteroscopy in the treatment of residual stones after percutaneous nephrolithotomy,and the role of 3D printed model in doctor-patient communication and clinical teaching.Methods: A total of 56 patients with residual calculi after percutaneous nephrolithotomy were enrolled in the First Affiliated Hospital of Guangxi Medical University from January 2015 to November 2017.All patients underwent ureteroscopic holmium laser lithotripsy.According to the principle of random distribution,the patients were divided into 3D printing group and control group.The 3D printing group extracted the DICOM file data of the patient's urinary CT scan,processed by computer software,and printed the kidney entity model through the Stratasys J750 full color 3D printer.The model is applied to preoperative planning,doctor-patient communication,and clinical teaching.The control group developed surgical planning based on CT scan results,preoperative communication between doctors and patients,and clinical teaching.The operation time,postoperative hospital stay,disposable stoneremoval rate,postoperative hemoglobin decrease,and complications were compared between the 3D print group and the control group.Results: The solid model of renal calculi in 22 patients was successfully printed,which can clearly show the three-dimensional structure of the renal pelvis and calyces,and the relationship between the position,size and collection system of the calculi.3D printing group and the control group in gender,age,body mass index,stone side don't,the residual stone diameter,number of CT value,residual stones,the lamp that residual calculi under cases,renal calyx less than 30°Angle cases,there was no statistically significant difference(P > 0.05).Postoperative hospitalization days,postoperative hemoglobin decreased value and complications were compared between the two groups,and the differences were not statistically significant(P > 0.05).The operation time and one-time stone clearance rate of the 3D printing group were better than the control group,and the differences were statistically significant(P < 0.05).Conclusion: 1.3D-printed kidney stone model can clearly show the three-dimensional structure of the renal pelvis and calyces,and the relationship between the location,size and collection system of the stones.The 3D-printed kidney stone model can improve the quality of doctor-patient communication and clinical teaching.2.3D-printed kidney stone model to assist soft ureteroscopy in the treatment of post-percutaneous nephrolithotomy residual stone is helpful to reduce the operation time and improve the one-time stone clearance rate,which is worthy of clinical recommendation.