Abstract:
: Objectives: To assess the effect of irrigation settings and the size of ureteral access sheath (UAS) on the maximal intra-pelvic pressure (IPPmax) during ureteroscopy (URS) in pigs. Materials and Methods: In supine position, three anesthetized female pigs underwent cystoscopy to insert a 6F ureteral catheter in each ureter. Pigs were then turned to prone position to establish a percutaneous access, insert a 10F nephrostomy tube in the kidney, and connect it to a urodynamic device. An 8F semi-rigid ureteroscope or the Flex-X2 Flexible Ureteroscope was used with two irrigation settings: gravity flow and manual pumping using a commercial pump. URS was performed without UAS and with the UAS 9.5/11, 12/14, 14/16 at the ureteropelvic junction and the IPPmax was recorded. Results: Under gravity irrigation, the recorded IPPmax during semi-rigid URS in the distal ureter and the renal pelvis was 0 and 30 cmH2O, respectively. Further, the IPPmax during flexible URS in the renal pelvis without UAS, with UAS 9.5/11.5, with UAS 12/14, and with UAS 14/16 was 23, 6, 2, and 1 cmH2O, respectively. Under manual pumping, the IPPmax during semi-rigid URS in the distal ureter and the renal pelvis was 84 and 105 cmH2O, respectively. Further, the IPPmax during flexible URS in the renal pelvis without UAS, with UAS 9.5/11.5, with UAS 12/14, and with UAS 14/16 was 45, 46, 18, and 1 cmH2O, respectively. Conclusion: Manual pumping can significantly increase the IPPmax to unsafe levels during URS. The UAS can significantly decrease the IPPmax, even under manual pumping. The larger the UAS, the lower the IPPmax. The use of UAS can render URS safer by acting as a safeguard against the consequences of increased IPP, even under forced irrigation.
journal_name
J Endouroljournal_title
Journal of endourologyauthors
Noureldin YA,Kallidonis P,Ntasiotis P,Adamou C,Zazas E,Liatsikos ENdoi
10.1089/end.2019.0317subject
Has Abstractpub_date
2019-09-01 00:00:00pages
725-729issue
9eissn
0892-7790issn
1557-900Xjournal_volume
33pub_type
杂志文章abstract:: Introduction: Elevated intrarenal pressure (IRP) during flexible ureterorenoscopy (FURS) is a predictor of postoperative complications. The aim of this study is to evaluate IRP during FURS in a porcine kidney model to determine the safest combination of irrigation device, ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2020.0838
更新日期:2020-11-05 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Repair of ureteral injuries and strictures often necessitates a major reconstructive procedure such as a psoas hitch, Boari flap, renal mobilization, ileal interposition, or autotransplantation. Tissue expanders have been used to elongate nerves and arteries. We examined the effects of acute ur...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1999.13.245
更新日期:1999-05-01 00:00:00
abstract:PURPOSE:To determine whether on-clamp partial nephrectomy (ON-PN) has any significant impact on long-term renal function in a two kidney model. PATIENTS AND METHODS:From November 1999 to July 2013, 607 patients underwent PN at our institution. After excluding patients with solitary kidneys, multiple renal masses, and ...
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doi:10.1089/end.2014.0476
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abstract::Extravesical robotic-assisted laparoscopic ureteral reimplantation in children is a challenging procedure. Our top-down suturing technique facilitates this reconstructive surgery. After mobilization of the ureter without the use of ureteral stent placement, the detrusor muscle is divided. Once adequate muscle flaps ar...
journal_title:Journal of endourology
pub_type: 杂志文章
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更新日期:2015-08-01 00:00:00
abstract:INTRODUCTION AND OBJECTIVE:Despite guidelines, routine 24-hour urine testing is completed in <10% of high-risk, recurrent stone formers. Using surrogates for metabolic testing, such as key patient characteristics, could obviate the cost and burden of this test while providing information needed for proper stone prevent...
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abstract:BACKGROUND AND PURPOSE:New-generation flexible ureteroscopes allow the management of proximal ureteral and intrarenal pathology with high success rates, including complete removal of ureteral and renal calculi. One problem is that the irrigation pressures generated within the collecting system can be significantly elev...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/089277904322836631
更新日期:2004-02-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章,随机对照试验
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更新日期:2017-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:To compare urinary stone size as measured by abdominal plain radiography (AXR) with stone size as measured by noncontrast three-dimensional spiral CT in patients with acute renal colic. PATIENTS AND METHODS:Patients presenting to the emergency room of a single institution with urinary stones tha...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/089277903770802245
更新日期:2003-11-01 00:00:00
abstract::Growing data suggest that lymphadenectomy is a critical component of the surgical management of urologic malignancies with both diagnostic and therapeutic benefit. The increased use of minimally invasive approaches for the management of urologic malignancies may be in conflict with the need for more extensive lymphade...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
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更新日期:2010-08-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2006.20.904
更新日期:2006-11-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章,随机对照试验
doi:10.1089/end.2006.0107
更新日期:2007-05-01 00:00:00
abstract:INTRODUCTION:Previous robot-assisted partial nephrectomy (RAPN) studies have identified various predictors of overall and major postoperative complications, but few have evaluated the specific role of these factors in the development of medical and surgical complications. In this study, we present an analysis of the mo...
journal_title:Journal of endourology
pub_type: 杂志文章
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更新日期:2017-03-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2017.0244
更新日期:2017-10-01 00:00:00
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更新日期:2020-12-02 00:00:00
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更新日期:2008-01-01 00:00:00
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journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
doi:10.1089/end.1996.10.147
更新日期:1996-04-01 00:00:00
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pub_type: 杂志文章
doi:10.1089/end.1997.11.239
更新日期:1997-08-01 00:00:00
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journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
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更新日期:2011-01-01 00:00:00
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pub_type: 临床试验,杂志文章,多中心研究
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更新日期:2000-04-01 00:00:00
abstract::Urinary incontinence may be the result of various forms of detrusor overactivity. Several surgical therapies have been devised, but with the exception of procedures to relieve urethral obstruction, none abolishes the overactivity or restores normal micturition. In general, ablative neurosurgery is considered only in p...
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pub_type: 杂志文章,评审
doi:10.1089/end.1996.10.213
更新日期:1996-06-01 00:00:00
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更新日期:2007-06-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章
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更新日期:2009-03-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1997.11.145
更新日期:1997-04-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1995.9.397
更新日期:1995-10-01 00:00:00