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Does High Ventilation Mode Affect the Success Rates of Retrograde Intrarenal Surgery? A Single-Blind Randomized,
Çağri Doğan1, Ayhan Şahin2, Haci Murat Akgül1
1Department of Urology, Faculty of Medicine, Namik Kemal University, Tekirdag, Turkey.
Journal of Endourology
|August 31, 2023
Summary
High ventilation (HV) mode during retrograde intrarenal surgery (RIRS) for kidney stones reduced operative time and improved laser targeting. This study suggests HV mode may enhance RIRS efficacy and surgeon comfort, especially in mobile kidneys.
Area of Science:
- Urology
- Anesthesiology
- Surgical Technology
Background:
- Retrograde intrarenal surgery (RIRS) is a first-line treatment for kidney stones <2 cm.
- Renal mobility can challenge surgical precision and success during RIRS.
- Optimizing ventilation strategies may improve RIRS outcomes.
Purpose of the Study:
- To evaluate the impact of two ventilation modes on RIRS efficacy and safety.
- To compare standard ventilation (SV) versus high ventilation (HV) during RIRS.
- To assess the effect of ventilation on operative time and surgical success.
Main Methods:
- Prospective trial of 144 patients undergoing RIRS from January to April 2023.
- Comparison between standard ventilation (SV: 8-10 mL/kg, 10-15 breaths/min) and high ventilation (HV: 6-8 mL/kg, 15-18 breaths/min).
- Surgeons were blinded to ventilation mode; anesthesiologists were informed.
Main Results:
- Mean operative time was significantly shorter in the HV group (58.4 min) compared to SV (62.9 min) (p=0.031).
- Stone fragmentation rate per minute was significantly higher in the HV group (p=0.003).
- Stone-free rates and postoperative complication rates were comparable between groups (p>0.05).
Conclusions:
- High ventilation (HV) mode during RIRS decreases operative time and enhances laser targeting effectiveness.
- HV mode may be preferred for RIRS in mobile kidneys to improve surgical efficiency and comfort.
- Further research may explore optimal ventilation parameters for RIRS.
