Abstract:Objective To compare the puncture success rate，trauma response，and recurrence rate between ultra -fine percutaneous nephrolithotomy under 3D printing modeling and traditional percutaneous nephrolithotomy in the treatment of <4 cm staghorn kidney stones. Methods A total of 102 patients with <4 cm staghorn kidney stones treated in the Department of Urology，Jiangnan University Medical Center from January 2022 to December 2023 were prospectively selected and randomly divided into two groups，with 51 cases each. The traditional group was treated with traditional percutaneous nephrolithotomy，while the 3D group was treated with ultra -fine percutaneous nephrolithotomy under 3Dprinting modeling. The one-time puncture success rate，one-stage stone clearance rate，surgical indicators，renal function indicators［serum creatinine（Scr）and blood urea nitrogen（BUN）］，trauma response indicators［norepinephrine（NE），cortisol（Cor），interleukin -8（IL -8）and C - reactive protein（CRP）］，total incidence of complications，and recurrencerate were compared between the two groups. Results The one - time puncture success rate（100.00% vs 88.24%，χ2=4.427，P<0.05），one-stage stone clearance rate（98.04% vs 82.35%，χ2=7.096，P<0.05）in the 3D group were higher than those in the traditional group. The operation time，nephrostomy tube removal time，and hospital stay in the 3D group were shorter than those in the traditional group（P<0.05），and the blood loss during surgery in the 3D group was lower than that in the traditional group（P<0.05）. Three days after surgery，the levels of serum Scr and BUN in both groups decreased compared with those before surgery，and there was no significant difference in the levels of serum Scr and BUN between the3D group and the traditional group（P>0.05）. Three days after surgery，the levels of serum NE，Cor，IL-8，and CRP in both groups increased compared with those before surgery，and the levels of serum NE，Cor，IL -8，and CRP in the 3D group were lower than those in the traditional group（P<0.05）. The recurrence rate in the 3D group was lower than that in the traditional group（3.92% vs 17.65%，χ2=4.993，P<0.05）. Conclusion In the treatment of <4 cm staghorn kidney stones，ultra-fine percutaneous nephrolithotomy under 3D printing modeling has a higher one-time puncture success rate and one-stage stone clearance rate，can effectively improve patient renal function，reduce trauma stress response，and lower the recurrence rate，with advantages such as shorter operation time，less blood loss during surgery，and faster recovery.