Abstract：
Ho: YAG laser lithotripsy is widely used for urinary stone treatment, 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. A sterile thermal probe was attached to a flexible ureterorenoscope and delivered into the calyceal system via the ureteral access sheath. Temperature changes were recorded with a T-type thermal probe with ± 0.1 °C accuracy. Laser power significantly influenced mean temperature, with a 4.981 °C difference between 14 W and 8 W laser power (p < 0.001). The mean temperature was 2.075 °C higher with gravity irrigation and 2.828 °C lower with manual pump irrigation (p = 0.038 and p = 0.005, respectively). Body mass index, laser power, irrigation model, and operator duty cycle explained 49.5% of mean temperature variability (Adj. R2 = 0.495). Laser power and operator duty cycle positively impacted mean temperature, while body mass index and specific irrigation models affected it negatively. Laser power and irrigation rate are critical for intrarenal temperature during Ho: YAG laser lithotripsy. Optimal settings and irrigation strategies are vital for minimizing thermal injury risk. This study underscores the need for ongoing research to understand and mitigate thermal effects during laser lithotripsy.
摘要：
Ho:YAG激光碎石术广泛用于泌尿系结石治疗,但人们仍然担心它对肾组织的热效应。这项研究旨在使用Ho：YAG激光逆行肾内手术监测肾结石治疗期间肾内温度的变化。15名患者入选。各种激光功率设置（0.8J/10Hz，1.2J/12Hz）和灌溉模式（10cc/min，15cc/min,20cc/min,重力灌溉,和手动泵灌溉)。将无菌热探针连接到柔性输尿管镜上，并通过输尿管进入鞘管输送到肾管系统中。用T型热探针以±0.1°C的精度记录温度变化。激光功率显著影响平均温度，14W和8W激光功率之间的差异为4.981°C（p<0.001）。重力灌溉的平均温度高2.075°C，手动泵灌溉的平均温度低2.828°C（分别为p=0.038和p=0.005）。身体质量指数,激光功率,灌溉模型,和操作员占空比解释了49.5％的平均温度变异性（Adj.R2=0.495)。激光功率和操作员占空比对平均温度有积极影响，而体重指数和特定的灌溉模型对其产生了负面影响。在Ho：YAG激光碎石术中，激光功率和冲洗速率对肾内温度至关重要。最佳设置和灌溉策略对于最大程度地减少热损伤风险至关重要。这项研究强调了正在进行的研究以了解和减轻激光碎石术中的热效应的必要性。
