Factors affecting the intraoperative calculi excretion during flexible ureteroscopy lithotripsy: an in vitro analysis
Objective To explore the parameters influencing intraoperative calculi excretion (ICE) during flexible ureteroscopy lithotripsy (fURL) using in vitro simulation experiments. Methods 3D-printed human kidney models were used to simulate the elimination of gravel during fURL. The factors influencing the ICE during fURL were analyzed by comparing the effects of different degrees of hydronephrosis (mild, moderate, and severe), surgical positions (supine and lateral position), ratios of endoscope-sheath diameter (RESD) (0.625, 0.725, and 0.825), gravel sizes (0.50–1.00 mm, 0.25–0.50 mm, and 0.10–0.25 mm), and ureteral access sheaths (UASs) (traditional UAS and negative-pressure UAS) on ICE. Results The impacts of various UAS, RESD, degree of hydronephrosis, surgical positions, and gravel sizes on ICE were all significant (p < 0.05). We found no evidence of multicollinearity for all the independent variables, and the linear regression equation fitted as $$\mathrm{ICE }\,({\mathrm{g}}/{\mathrm{min}}) = 0.102 + 0.083*\mathrm{UAS\,grade }- 0.050*\mathrm{RESD\,grade }- 0.048*\mathrm{hydronephrosis\,grade }+ 0.065*\mathrm{position\,grade }- 0.027*\mathrm{gravel\,size\,grade}$$ (R2 = 0.569). Conclusion Employing negative-pressure UAS, smaller RESD, milder hydronephrosis, lateral position, and smaller gravel size contribute to improved ICE during fURL. Among them, the adoption of negative-pressure UAS had the most substantial effects..
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E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
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Zur Gesamtaufnahme - volume:42 |
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| Enthalten in: |
World journal of urology - 42(2024), 1 vom: 09. März |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Song, Baiyang [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
3D-printed model |
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© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
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| doi: |
10.1007/s00345-024-04794-9 |
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SPR055090117 |
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| 520 | |a Objective To explore the parameters influencing intraoperative calculi excretion (ICE) during flexible ureteroscopy lithotripsy (fURL) using in vitro simulation experiments. Methods 3D-printed human kidney models were used to simulate the elimination of gravel during fURL. The factors influencing the ICE during fURL were analyzed by comparing the effects of different degrees of hydronephrosis (mild, moderate, and severe), surgical positions (supine and lateral position), ratios of endoscope-sheath diameter (RESD) (0.625, 0.725, and 0.825), gravel sizes (0.50–1.00 mm, 0.25–0.50 mm, and 0.10–0.25 mm), and ureteral access sheaths (UASs) (traditional UAS and negative-pressure UAS) on ICE. Results The impacts of various UAS, RESD, degree of hydronephrosis, surgical positions, and gravel sizes on ICE were all significant (p < 0.05). We found no evidence of multicollinearity for all the independent variables, and the linear regression equation fitted as $$\mathrm{ICE }\,({\mathrm{g}}/{\mathrm{min}}) = 0.102 + 0.083*\mathrm{UAS\,grade }- 0.050*\mathrm{RESD\,grade }- 0.048*\mathrm{hydronephrosis\,grade }+ 0.065*\mathrm{position\,grade }- 0.027*\mathrm{gravel\,size\,grade}$$ (R2 = 0.569). Conclusion Employing negative-pressure UAS, smaller RESD, milder hydronephrosis, lateral position, and smaller gravel size contribute to improved ICE during fURL. Among them, the adoption of negative-pressure UAS had the most substantial effects. | ||
| 650 | 4 | |a 3D-printed model |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Flexible ureteroscopy lithotripsy |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Intraoperative calculi excretion |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Negative-pressure UAS |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Ratios of endoscope-sheath diameter |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Hydronephrosis |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Cheng, Yue |0 (orcid)0000-0003-0357-0810 |4 aut | |
| 700 | 1 | |a Lu, Yunfei |4 aut | |
| 700 | 1 | |a Rong, Hao |4 aut | |
| 700 | 1 | |a Huang, Ting |4 aut | |
| 700 | 1 | |a Shi, Jingyu |4 aut | |
| 700 | 1 | |a Fang, Li |0 (orcid)0000-0003-0870-1066 |4 aut | |
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