MP29-15: Clinical results analysis of the first disposable intrarenal pressure measuring flexible ureteroscope in China
Saturday, May 4, 2024 9:30 AM to 11:30 AM · 2 hr. (US/Central)
302B
Abstract
Information
Full Abstract and Figures
Author Block
Yubao Liu*, Hai feng Song, Jianxing Li, Beijing, China
Introduction
To analyze and evaluate the clinical experience and application value of using Chinese first disposable “Zebra” intrarenal pressure (IRP) measuring flexible ureteroscope (Happiness Works Company) for the treatment of <2cm renal stones.
Methods
A single-arm retrospective observational analysis of 35 patients admitted to our hospital who underwent RIRS using IRP measuring flexible ureteroscope. The mean age of patients was 42.3±6.1, BMI was 24.2±2.6 kg/m2, and the maximum diameter of the stone was 1.6±0.4 cm. 13 (37.1%) were lower pole renal stones and 22 (62.9%) were non lower pole renal stones. The pressure threshold was set at 30 mmHg, and fluid perfusion was performed using saline suspended at a height of 1.5 m. According to the examination of ureteroscopy and the surgeon's experience, choose the ureteral access sheath(UAS) size of F11-13 or F12-14. Summarize and analyze the mean normal IRP, mean maximum IRP, mean frequency and cumulative time of exceeding pressure threshold, factors contributing to a significant increase in pressure,postoperative fever, and postoperative VAS score.
Results
All 35 procedures were performed successfully. The sheath was positioned low (upper ureter) in 9 cases (25.7%) and normal position in 28 cases (74.3%). The mean normal IRP was 16.2±5.7 mmHg, the mean maximum IRP was 48.2±.6.5 mmHg, the mean frequency and cumulative time exceeding the pressure threshold were 4.6±1.2 and 35.2±11.3s. The mean maximum IRP, the mean frequency of exceeding the threshold and the cumulative time were significantly increase when UAS was positioned low (68.1±8.3 mmHg vs 34.4±6.2 mmHg, 9.2±2.5 vs 3.1±0.6, 63.3±10.7s vs 24.6±4.2s, P<0.05). During in situ lithotripsy of the renal lower pole, the mean normal IRP and mean maximum IRP were higher than those at other locations (25.6±2.8mmHg vs 13.9±3.6mmHg, 41.7±5.2 mmHg vs 32.5±4.2 mmHg, P<0.05). There was no significant difference between the IRP measured using different types of UAS (P>0.05).There were 3 cases (8.6%) with postoperative fever (37.5-38.5?), all of which had a high mean maximum IRP (65.7mmHg) and a longer cumulative high-pressure time (69.5s). The VAS score is 2.52±0.21. There is no occurrence of Clavien Dindo=Grade II complications.
Conclusions
A disposable IRP measuring flexible ureteroscope can monitor real-time changes in renal pressure in RIRS, accurately displaying pressure fluctuations at the lithotripsy site, so that the operator can adjust the intraoperative parameters and optimize the surgical strategy according to the data changes at any time, thus guaranteeing the safety of the surgery. Factors such as the lower position of the UAS, small calyceal neck, or in situ lithotripsy in the lower pole can easily cause poor fluid reflux and thus increase IRP.
Source Of Funding
no
Author Block
Yubao Liu*, Hai feng Song, Jianxing Li, Beijing, China
Introduction
To analyze and evaluate the clinical experience and application value of using Chinese first disposable “Zebra” intrarenal pressure (IRP) measuring flexible ureteroscope (Happiness Works Company) for the treatment of <2cm renal stones.
Methods
A single-arm retrospective observational analysis of 35 patients admitted to our hospital who underwent RIRS using IRP measuring flexible ureteroscope. The mean age of patients was 42.3±6.1, BMI was 24.2±2.6 kg/m2, and the maximum diameter of the stone was 1.6±0.4 cm. 13 (37.1%) were lower pole renal stones and 22 (62.9%) were non lower pole renal stones. The pressure threshold was set at 30 mmHg, and fluid perfusion was performed using saline suspended at a height of 1.5 m. According to the examination of ureteroscopy and the surgeon's experience, choose the ureteral access sheath(UAS) size of F11-13 or F12-14. Summarize and analyze the mean normal IRP, mean maximum IRP, mean frequency and cumulative time of exceeding pressure threshold, factors contributing to a significant increase in pressure,postoperative fever, and postoperative VAS score.
Results
All 35 procedures were performed successfully. The sheath was positioned low (upper ureter) in 9 cases (25.7%) and normal position in 28 cases (74.3%). The mean normal IRP was 16.2±5.7 mmHg, the mean maximum IRP was 48.2±.6.5 mmHg, the mean frequency and cumulative time exceeding the pressure threshold were 4.6±1.2 and 35.2±11.3s. The mean maximum IRP, the mean frequency of exceeding the threshold and the cumulative time were significantly increase when UAS was positioned low (68.1±8.3 mmHg vs 34.4±6.2 mmHg, 9.2±2.5 vs 3.1±0.6, 63.3±10.7s vs 24.6±4.2s, P<0.05). During in situ lithotripsy of the renal lower pole, the mean normal IRP and mean maximum IRP were higher than those at other locations (25.6±2.8mmHg vs 13.9±3.6mmHg, 41.7±5.2 mmHg vs 32.5±4.2 mmHg, P<0.05). There was no significant difference between the IRP measured using different types of UAS (P>0.05).There were 3 cases (8.6%) with postoperative fever (37.5-38.5?), all of which had a high mean maximum IRP (65.7mmHg) and a longer cumulative high-pressure time (69.5s). The VAS score is 2.52±0.21. There is no occurrence of Clavien Dindo=Grade II complications.
Conclusions
A disposable IRP measuring flexible ureteroscope can monitor real-time changes in renal pressure in RIRS, accurately displaying pressure fluctuations at the lithotripsy site, so that the operator can adjust the intraoperative parameters and optimize the surgical strategy according to the data changes at any time, thus guaranteeing the safety of the surgery. Factors such as the lower position of the UAS, small calyceal neck, or in situ lithotripsy in the lower pole can easily cause poor fluid reflux and thus increase IRP.
Source Of Funding
no