Application of three-dimensional image reconstruction technology based on high-resolution CT in pyeloplasty

Background: Three-dimensional (3D) image reconstruction technology is widely used in surgical operations for its intuitive visualization. Pyeloplasty requiresprecise cutting and suturing. The reconstruction technology can accurately determine the location and scope of the stenosis at the junction of the renal pelvis and ureter and the relationship with the surrounding vasculature. The purpose of this article is to retrospective evaluate the application value of image reconstruction technology in pyeloplasty based on high-resolution 3D CT images.

Methods: A total of 20 patients with renal pelvic ureteral junction obstruction admitted to our hospital from August 2019 to August 2020 were selected. In this group, left pyeloplasty was performed in 8 patients and right pyeloplasty in 12 patients. In terms of conditions, there was 1 case with secondary pyeloplasty, 6 cases of patients with kidney stones, 2 cases with renal ectopic blood vessels, 1 case with renal prolapse, 1 case with horseshoe kidney, and 1 case with ureteral polyps. There were 12 males and 8 females, with an average age of 34.65±10.67 years and an average body mass index (BMI) of 22.48±3.03 kg/m². In all patients, 3D CT reconstruction technology was used to guide the formulation of robot-assisted laparoscopic pyeloplasty plans; verify the consistency between the actual operation and the preoperative planning; and observe the operation time, blood loss, postoperative exhaust time, indwelling drainage tube time, and follow-up for comorbidities.

Results: The operation was successful in all 20 patients. The actual operation was 100% consistent with the preoperative planning, the operative time was 160.80±63.26 min, the intraoperative blood loss was 47±30.45 mL, the postoperative exhaust time was 1.15±0.37 days, the drainage tube indwelling time was 4.35±1.50 days, and the average follow-up time was 7.95±3.41 months. There were no complications.

Conclusions: Three-dimensional image reconstruction technology based on high-resolution CT has high clinical application value in the treatment of ureteropelvic junction obstruction (UPJO), which simplifies the operation process and shortens the operation time, and is a valuable tool for auxiliary surgeons in devising the operation plan.