Does tidal volume during mechanical ventilation affect pediatric retrograde intrarenal surgery outcomes?

Area of Science:

• Pediatric Urology
• Minimally Invasive Surgery
• Anesthesiology

Background:

• Retrograde intrarenal surgery (RIRS) is a key treatment for pediatric kidney stones.
• Mechanical ventilation (MV) parameters, including tidal volume, can influence surgical conditions.
• Optimizing MV settings may enhance RIRS outcomes in pediatric patients.

Purpose of the Study:

• To investigate the impact of tidal volume during MV on outcomes of pediatric RIRS.
• To compare stone-free rates and complication profiles based on tidal volume settings.

Main Methods:

• Retrospective analysis of pediatric RIRS cases (January 2018 - January 2023).
• Patients divided into two groups based on tidal volume: ≤7 ml/kg (Group 1) and >7 ml/kg (Group 2).
• Comparison of demographic, clinical, perioperative, and postoperative data between groups.

Main Results:

• 83 pediatric patients were analyzed; groups were comparable in demographics and clinical characteristics.
• No significant differences in stone characteristics or surgical parameters were observed.
• A higher stone-free rate was found in the lower tidal volume group (Group 1) at one month (90.3% vs. 71.1%, p=0.03).
• No high-grade or anesthesia-related complications occurred.

Conclusions:

• Reducing tidal volume during pediatric RIRS may lead to improved stone-free rates.
• Lower tidal volumes potentially enhance operative field stability and laser targeting efficacy.
• This strategy may improve surgical comfort and outcomes in pediatric RIRS.