Micro-ureteroscopy vs. ureteroscopy: effects of miniaturization on renal vascularization and intrapelvic pressure

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Title: Micro-ureteroscopy vs. ureteroscopy: effects of miniaturization on renal vascularization and intrapelvic pressure
Authors: Caballero-Romeu, Juan-Pablo | Galán-Llopis, Juan-Antonio | Soria, Federico | Morcillo-Martín, Esther | Caballero, Pablo | Garcia, Alejandro | De La Cruz-Conty, Julia E. | Romero-Maroto, Jesús
Research Group/s: Grupo Balmis de Investigación en Salud Comunitaria e Historia de la Ciencia
Center, Department or Service: Universidad de Alicante. Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia
Keywords: Ureteroscopy | Urolithiasis | Ureteral stones | Miniaturization | Model, animal | Minimally invasive surgical procedures
Knowledge Area: Enfermería
Issue Date: May-2018
Publisher: Springer Berlin Heidelberg
Citation: World Journal of Urology. 2018, 36(5): 811-817. doi:10.1007/s00345-018-2205-y
Abstract: Purpose Ureteroscopy (URS) is related to complications, as fever or postoperative urinary sepsis, due to high intrapelvic pressure (IPP) during the procedure. Micro-ureteroscopy (m-URS) aims to reduce morbidity by miniaturizing the instrument. The objective of this study is to compare IPP and changes in renal haemodynamics, while performing m-URS vs. conventional URS. Methods A porcine model involving 14 female pigs was used in this experimental study. Two surgeons performed 7 URS (8/9.8 Fr), for 45 min, and 7 m-URS (4.85 Fr), for 60 min, representing a total of 28 procedures in 14 animals. A catheter pressure transducer measured IPP every 5 min. Haemodynamic parameters were evaluated by Doppler ultrasound. The volume of irrigation fluid employed in each procedure was also measured. Results The range of average pressures was 5.08–14.1 mmHg in the m-URS group and 6.08–20.64 mmHg in the URS (NS). 30 mmHg of IPP were not reached in 90% of renal units examined with m-URS, as compared to 65% of renal units in the URS group. Mean peak diastolic velocity decreased from 15.93 to 15.22 cm/s (NS) in the URS group and from 19.26 to 12.87 cm/s in the m-URS group (p < 0.01). Mean resistive index increased in both groups (p < 0.01). Irrigation fluid volume used was 485 mL in the m-URS group and 1475 mL in the URS group (p < 0.001). Conclusions m-URS requires less saline irrigation volumes than the conventional ureteroscopy and increases renal IPP to a lesser extent.
Sponsor: Authors received research funds from a public research institute (ISABIAL-FISABIO) and from Presurgy SL.
URI: http://hdl.handle.net/10045/75211
ISSN: 0724-4983 (Print) | 1433-8726 (Online)
DOI: 10.1007/s00345-018-2205-y
Language: eng
Type: info:eu-repo/semantics/article
Rights: © Springer-Verlag GmbH Germany, part of Springer Nature 2018
Peer Review: si
Publisher version: https://doi.org/10.1007/s00345-018-2205-y
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