Data Sheet 1_Three-dimensional virtual reconstruction combined with the S.T.O.N.E. score improves outcomes of PCNL: a multicenter study.docx

Stratified multivariable logistic regression analyses were performed to compare 3D-VR techniques against the conventional ultrasound-guided control group across risk-based subgroups (P < 0.05).</p>Results<p>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 (P < 0.05).

The 3D-VR-Template group showed further reductions in these indicators and a significantly higher stone-free rate (P < 0.05). No statistically significant differences existed between the two 3D technology groups. S.T.O.N.E. score > 9 was an independent risk factor for low stone-free rate (OR = 2.31, 95%CI: 1.12–4.76, P = 0.02).

Stratified analysis revealed that while the Simple 3D-VR technique doubled stone-free rate in low-to-moderate risk patients (OR = 2.07, 95%CI: 1.04–4.03, P = 0.039), the 3D-VR-Template technology provided a superior fourfold advantage (OR = 4.15, 95%CI: 1.07–6.14, P = 0.040) specifically in high-risk cases.</p>Conclusion<p>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.</p>