Jingfei Teng1, Yi Wang2, Zhuomin Jia1, Yawei Guan1, Weiwei Fei3, Xing Ai4,5. 1. Department of Urology, The Seventh Medical Center of Chinese PLA General Hospital, No 5 Nanmencang, Beijing, 100700, China. 2. Department of Urology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, 100048, China. 3. Department of Anesthesiology, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, 100700, China. 4. Department of Urology, The Seventh Medical Center of Chinese PLA General Hospital, No 5 Nanmencang, Beijing, 100700, China. aixing0007@163.com. 5. The Second School of Clinical Medicine, Southern Medical University, Beijing, 100700, China. aixing0007@163.com.
Abstract
PURPOSE: To evaluate calyceal irrigation fluid temperature changes during flexible ureteroscopic Ho:YAG laser lithotripsy. METHODS: Between May 2019 and January 2020, patients with kidney stones undergoing flexible ureteroscopic Ho:YAG laser lithotripsy were enrolled. A K-type thermocouple was applied for intraoperative temperature measurement. Laser was activated at different power (1 J/20 Hz and 0.5 J/20 Hz) and irrigation (0 ml/min, 15 ml/min and 30 ml/min) settings, temperature-time curve was drawn and time needed to reach 43 °C without irrigation was documented. RESULTS: Thirty-two patients were enrolled in our study. The temperature-time curve revealed a quick temperature increase followed by a plateau. With 15 ml/min or 30 ml/min irrigation, 43 °C was not reached after 60 s laser activation at both 1 J/20 Hz and 0.5 J/20 Hz. At the power setting of 1 J/20 Hz and irrigation flow rate of 15 ml/min, the temperature rise was significantly higher than other groups. Without irrigation, the time needed to reach 43 °C at 1 J/20 Hz was significantly shorter than that at 0.5 J/20 Hz (8.84 ± 1.41 s vs. 13.71 ± 1.53 s). CONCLUSION: Ho:YAG laser lithotripsy can induce significant temperature rise in calyceal fluid. With sufficient irrigation, temperatures can be limited so that a toxic thermal dose is not reached, when irrigation is closed, the temperature increased sharply and reached 43 °C in a few seconds.
PURPOSE: To evaluate calyceal irrigation fluid temperature changes during flexible ureteroscopic Ho:YAG laser lithotripsy. METHODS: Between May 2019 and January 2020, patients with kidney stones undergoing flexible ureteroscopic Ho:YAG laser lithotripsy were enrolled. A K-type thermocouple was applied for intraoperative temperature measurement. Laser was activated at different power (1 J/20 Hz and 0.5 J/20 Hz) and irrigation (0 ml/min, 15 ml/min and 30 ml/min) settings, temperature-time curve was drawn and time needed to reach 43 °C without irrigation was documented. RESULTS: Thirty-two patients were enrolled in our study. The temperature-time curve revealed a quick temperature increase followed by a plateau. With 15 ml/min or 30 ml/min irrigation, 43 °C was not reached after 60 s laser activation at both 1 J/20 Hz and 0.5 J/20 Hz. At the power setting of 1 J/20 Hz and irrigation flow rate of 15 ml/min, the temperature rise was significantly higher than other groups. Without irrigation, the time needed to reach 43 °C at 1 J/20 Hz was significantly shorter than that at 0.5 J/20 Hz (8.84 ± 1.41 s vs. 13.71 ± 1.53 s). CONCLUSION: Ho:YAG laser lithotripsy can induce significant temperature rise in calyceal fluid. With sufficient irrigation, temperatures can be limited so that a toxic thermal dose is not reached, when irrigation is closed, the temperature increased sharply and reached 43 °C in a few seconds.
Authors: Dmitry Enikeev; Andrey Morozov; Mark Taratkin; Vincent Misrai; Enrique Rijo; Alexei Podoinitsin; Svetlana Gabdullina; Thomas R W Herrmann Journal: World J Urol Date: 2020-09-17 Impact factor: 4.226
Authors: Patrick Rice; Bhaskar Kumar Somani; Udo Nagele; Thomas R W Herrmann; Theodoros Tokas Journal: World J Urol Date: 2022-03-31 Impact factor: 3.661