{
  "abstract": "To compare the effects of Color Doppler flow imaging (CDFI) versus conventional two-dimensional ultrasound (2D-US) on bleeding control and surgical outcomes during percutaneous nephrolithotomy (PCNL). Between January 2023 and December 2024, 268 consecutive patients were enrolled in this retrospective-prospective hybrid cohort study. 134 patients received conventional two-dimensional ultrasound-guided puncture (2023 historical control cohort), and another 134 patients received CDFI-guided puncture that avoided renal vessels ≥ 2 mm (2024 observational cohort). This trial was retrospectively registered in ChiCTR (ChiCTR2500114024) on December 5, 2025. The primary endpoint was intraoperative estimated blood loss; postoperative hemoglobin decline was set as a supporting collinear derived measure. Secondary endpoints included transfusion, interventional embolization, stone-free rate, and perirenal hematoma. Overlap-weighting was used to balance baseline stone burden, and Benjamini-Hochberg FDR correction was applied for multiple secondary comparisons. After weighting, CDFI-guided PCNL significantly reduced the primary endpoint of intraoperative blood loss (304.8 ± 17.3 mL vs. 373.3 ± 23.8 mL; effect − 68.6 mL; 95% CI − 126.1, − 11.0; P = 0.020). The collinear supporting measure of postoperative hemoglobin decline showed a consistent reduction (9.51 ± 0.53 g L⁻¹ vs. 11.73 ± 0.75 g L⁻¹; effect − 2.22 g L⁻¹; 95% CI − 4.02, − 0.42; P = 0.016), but was not treated as an independent confirmatory outcome. Stone-free rates, transfusion, embolization, and hematoma rates were comparable after FDR correction (all P > 0.05). CDFI guidance during 18-Fr single-tract PCNL is associated with a statistically significant reduction in intraoperative estimated blood loss, with a consistent supporting trend in hemoglobin decline, without compromising stone clearance efficacy. These findings support CDFI as a useful adjunctive optimization tool for renal access, but confirmatory multicenter randomized trials are still required.",
  "abstract_shown": true,
  "affiliations": [
    "¹Department of Urology, Hechi Hospital, The First Affiliated Hospital of Guangxi Medical University"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Xian-Yong Yan"
    },
    {
      "affs": [
        0
      ],
      "name": "Jing-Zhi Huang"
    },
    {
      "affs": [
        0
      ],
      "name": "Qing-Fan Wei"
    },
    {
      "affs": [
        0
      ],
      "name": "Rong-Yuan Wei"
    },
    {
      "affs": [
        0
      ],
      "name": "Jiang Qin"
    },
    {
      "affs": [
        0
      ],
      "name": "Hai Lu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bmx44nckdjwc0.bib",
  "cited_by": 0,
  "doi": "10.1038/s41598-026-67426-9",
  "fulltext_url": "https://doi.org/10.1038/s41598-026-67426-9",
  "id": "bmx44nckdjwc0",
  "issns": [
    "2045-2322"
  ],
  "landing_url": "https://doi.org/10.1038/s41598-026-67426-9",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "Q"
    ],
    [
      "lcc",
      "R"
    ],
    [
      "openalex",
      "2740|Kidney Stones and Urolithiasis Treatments"
    ]
  ],
  "openalex": "W7204261885",
  "pdf_url": "https://www.nature.com/articles/s41598-026-67426-9_reference.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-08-01",
  "publisher": "Nature Portfolio",
  "ris": "https://research.draconitic.com/paper/bmx44nckdjwc0.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:45:56Z",
      "native_id": "16a97f950c5a4c6f9cbec7274f73e098",
      "source": "doaj",
      "url": "https://doi.org/10.1038/s41598-026-67426-9"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Kidney Stones and Urolithiasis Treatments",
      "subfield": "general"
    }
  ],
  "title": "Color Doppler ultrasound-guided tract creation reduces bleeding in percutaneous nephrolithotomy: an overlap-weighted cohort study",
  "title_text": "Color Doppler ultrasound-guided tract creation reduces bleeding in percutaneous nephrolithotomy: an overlap-weighted cohort study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T14:20:44Z",
  "url": "https://research.draconitic.com/paper/bmx44nckdjwc0",
  "venue": "Scientific Reports",
  "versions": []
}