Review of CT-Guided Puncture Device in PCNL shows reduced time and radiation in small preliminary report

This preliminary report presents a review and synthesis of data from 51 adult patients undergoing percutaneous nephrolithotomy. The study compares a CT-Guided Puncture Device against a free-hand CT-guided group and an X-ray-guided group. The primary focus is on puncture accuracy and stone-free rates, with secondary outcomes including puncture time, success rate, number of punctures, effective dose, number of CT scans, radiation exposure, and complications.

The authors found that the CT-Guided Puncture Device significantly reduced puncture time to 10.88 ± 2.07 minutes compared to the other two groups. Puncture success rate was 100% in the device group, which was significantly better than the comparators. The number of punctures was 1.82 ± 0.73, also significantly reduced compared to the other groups.

Regarding radiation metrics, the effective dose was reduced by 11.2% versus the free-hand CT-guided group with a p-value of 0.006. The number of CT scans was reduced by 23.6% versus the free-hand CT-guided group, also with a p-value of 0.006. Absolute numbers for these outcomes were not reported. Adverse events, serious adverse events, discontinuations, and tolerability were not reported in this source.

The authors note limitations including the small sample size of 51 and the preliminary nature of the report. Generalizability should not be overstated. Long-term safety outcomes are not reported. The authors suggest the approach is especially beneficial for novices in PCNL, but practice relevance remains cautious given the study design.