Relation between renal pelvic pressure and ratio of endoscope-sheath diameter during percutaneous nephrolithotomy
10.3760/cma.j.issn.1000-6702.2018.09.015
- VernacularTitle:经皮肾镜取石术术中肾盂内压与镜鞘比的关系
- Author:
GuoHai XIE
1
;
Wanzhang LIU
;
Li FANG
;
Zejun YAN
;
Jiaqi ZHU
;
Guanlin LIU
;
Zhong ZHENG
;
Yue CHENG
Author Information
1. 315010,宁波市第一医院泌尿肾病中心泌尿外科
- Keywords:
Percutaneous nephrolithotomy;
Renal pelvic pressure;
nephrostomy tract size;
Ratio of endoscope-sheath diameter
- From:
Chinese Journal of Urology
2018;39(9):703-706
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the influence of ratio of endoscope-sheath diameter on renal pelvic pressure during PCNL.Methods The model of 24 isolated adult porcine kidneys were used to imitate percutaneous nephrolithotomy from September 2016 to June 2017.Each tract was established (F12,F14 and F16).Three kinds of endoscopes (F8 all-seeing needle percutaneous nephroscope,F6/7.5 and F8/ 9.8 rigid ureteroscope),input a 200μm laser,were adopted.There were 8 combinations,and 3 kidneys were used for each one.Renal pelvic pressure was measured 3 times repeatedly in every combination with steady irrigation (50,100,150,200,250,300,350,400,450,500 cmH2O).Results The linear equations,ratios of endoscope-sheath diameter and highest renal pelvic pressures for each combination were:F8-F12,Pr =0.026 P0-1.533,0.67,12.2 ± 0.54;F6/7.5-F 12,Pr =0.112 P0-5.001,0.92,51.2 ± 0.93;F8-F 14,Pr =0.010P0 + 1.067,0.58,6.2 ± 0.48;F6/7.5-F14,Pr =0.020P0 + 1.000,0.79,10.8 ± 0.46;F8/9.8-F14,Pr =0.144P0 +20.933,0.87,84.7 ± 1.17;F8-F16,Pr =0.005P0 + 1.067,0.50,2.8 ±0.34;F6/7.5-F16,Pr =0.009P0 + 0.533,0.68,5.1 ± 0.32;F8/9.8-F16,Pr =0.020P0 + 2.200,0.75,12.6 ± 0.56.The combinations of F6/7.5-F12 and F8/9.8-F14 might lead to a high renal pelvic pressure without proper irrigation (＜401.7 cmH2O for F6/7.5-F12;＜ 132.4 cmH2O for F8/9.8-F14).Conclusion In order to keep a safe pressure,a proper ratio of endoscope-sheath diameter (＜ 0.80) and appropriate irrigation must be considered.
