ArticleFrontiers in surgery2026
Three-dimensional virtual reconstruction combined with the S.T.O.N.E. score improves outcomes of PCNL: a multicenter study.
Article in Frontiers in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To evaluate the impact of three-dimensional visualization virtual reconstruction (3D-VR) combined with the S.T.O.N.E. score on the efficacy of percutaneous nephrolithotomy (PCNL). Methods: A prospective cohort study enrolled patients with kidney stones from six centers between July 2022 and July 2025. Participants were divided into a conventional ultrasound-guided control group and a 3D-VR group based on the surgical strategy selected by patients after informed consent. The latter group was further subdivided into a Simple 3D-VR group and a 3D-VR-Template group. Each group was further categorized into low-to-moderate risk (S.T.O.N.E. score ≤ 9) and high-risk (S.T.O.N.E. score > 9) subgroups. Perioperative indicators were compared, and the relationship between scores and stone-free rates was analyzed using logistic regression. Stratified multivariable logistic regression analyses were performed to compare 3D-VR techniques against the conventional ultrasound-guided control group across risk-based subgroups ( Results: No baseline differences were observed among the three groups. Compared with the conventional ultrasound-guided control group, the Simple 3D-VR group alone demonstrated reduced intraoperative blood loss, shorter nephroscopic access establishment time, and shorter hospital stay ( Conclusion: Combining 3D-VR with S.T.O.N.E. scoring may optimize PCNL surgical planning, reduce intraoperative bleeding and shorten hospital stay, and may improve stone-free rate especially in patients with high-risk complex stones. Further well-designed controlled studies are warranted to confirm its clinical value.
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