Zhang Jiaxing, Dai Liangliang, Xu Jiashun, Song Rijin, Meng Xianghu, Shi Honglei
Department of Urology, Wujin Hospital Affiliated with Jiangsu University, 213004, Changzhou, China.
Department of Urology, Wujin Clinical College of Xuzhou Medical University, Changzhou, 213004, China.
Urolithiasis. 2025 Jul 28;53(1):145. doi: 10.1007/s00240-025-01817-x.
To investigate the changes in intrarenal pressure (IRP) and intrarenal temperature (IRT) in different surgical positions during retrograde intrarenal flexible ureteroscopic lithotripsy (RIRS) using a newly developed in vitro kidney model. Changes in IRP and IRT were tested in the conventional lithotomy position (CLP), the Trendelenburg position(TP), the Galdakao-modified supine Valdivia (GMSV) position, and the prone split-leg (PSL) position. Irrigation flow rates (FRs) of 0, 10, 20 and 30 ml/min were selected. The irrigation pressures (IPs) were 50, 100, 150, 200, 250, 300, 350 and 400 mmHg. IRP and IRT were recorded using an in vitro model under different surgical positions and combinations of FR and IP. The group with the highest IRT was the combination of TP and 0 ml/min, and the mean temperature reached 42.0 ℃. The group with the lowest IRT group was subject to the combination of PSL and 30 ml/min, and the mean temperature reached 38.0 ℃. Under the same IP, the IRP significantly differed across different surgical positions (P < 0.01). The IRP of PSL was always higher than those of the other three positions, whereas the IRP of GMSV was always lower than those of the other positions. When the IP was 400 mmHg, the pressure measured in the PSL position was 42.4 cmHO. The mean intrarenal temperature is greater in the TP, whereas the mean intrarenal pressure is greater in the PSL. When urologists choose the above two positions during surgery, they need to pay more attention to the intrarenal temperature and intrarenal pressure to reduce intraoperative injury to patients and postoperative complications.
使用新开发的体外肾脏模型，研究逆行性肾内软性输尿管镜碎石术（RIRS）期间不同手术体位下的肾内压（IRP）和肾内温度（IRT）变化。在传统截石位（CLP）、头低脚高位（TP）、改良仰卧瓦尔迪维亚高氏位（GMSV）和俯卧分腿位（PSL）测试IRP和IRT的变化。选择0、10、20和30毫升/分钟的冲洗流速（FR）。冲洗压力（IP）为50、100、150、200、250、300、350和400毫米汞柱。在不同手术体位以及FR和IP的组合下，使用体外模型记录IRP和IRT。IRT最高的组是TP与0毫升/分钟的组合，平均温度达到42.0℃。IRT最低的组是PSL与30毫升/分钟的组合，平均温度达到38.0℃。在相同IP下，不同手术体位的IRP有显著差异（P<0.01）。PSL的IRP始终高于其他三个体位，而GMSV的IRP始终低于其他体位。当IP为400毫米汞柱时，在PSL体位测得的压力为42.4厘米水柱。TP的平均肾内温度较高，而PSL的平均肾内压较高。泌尿外科医生在手术中选择上述两种体位时，需要更加关注肾内温度和肾内压，以减少术中对患者的损伤和术后并发症。
