Monitoring Intrarenal Temperature Changes During Ho:YAG Laser Lithotripsy in Patients Undergoing Retrograde Intrarenal Surgery: A Novel Clinical Study

crossref(2024)

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摘要
Abstract Ho:YAG laser lithotripsy is a widely used technique for treating urinary stones, but concerns persist regarding its thermal effects on renal tissues. This study aimed to monitor intrarenal temperature changes during kidney stone treatment using retrograde intrarenal surgery with Ho:YAG laser. Fifteen patients were enrolled. Various laser power settings (0.8 J/10 Hz, 1.2 J/12 Hz) and irrigation modes (10 cc/min, 15 cc/min, 20 cc/min, gravity irrigation, and manual pump irrigation) were used. Temperature changes were recorded with a T-type thermal probe with ± 0.1°C accuracy. The laser power had the most significant effect on the mean temperature, with the mean temperature being 4.981°C higher for the 14 W laser power than for the 8 W laser power (p < 0.001). The mean temperature was 2.075°C higher in the gravity irrigation model and 2.828°C lower in the manual pump irrigation model (p = 0.038 and p = 0.005, respectively). Body mass index, laser power, irrigation model and operator duty cycle explained approximately 49.5% of the mean temperature (Adj. R2 = 0.495). Results revealed that laser power and operator duty cycle positively impacted mean temperature, suggesting that higher settings and longer activation periods led to increased temperature. Conversely, increases in body mass index and utilization of certain irrigation models were associated with decreased mean temperature. Laser power and irrigation rate are critical determinants of intrarenal temperature during Ho:YAG laser lithotripsy. Optimal settings and irrigation strategies are essential for minimizing thermal injury risk. This study highlights the importance of ongoing research to better understand and mitigate thermal effects during laser lithotripsy.
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