METHODS: A 9.5Fr disposable ureteroscope was inserted into a silicone kidney-ureter model with its tip positioned at the renal pelvis. Irrigation was delivered through the ureteroscope at 100 cm above the renal pelvis. A Y-shaped adapter was fitted onto the model\'s renal pelvis port, accommodating a pressure sensor and a 4 Fr ureteral access catheter (UAC) through each limb. The drainage flowrate through the UAC tip was measured for 60 s each run. The distal tip of the UAC was placed at various heights below or above the center of the renal pelvis to create a siphoning effect. All trials were performed in triplicate for two lengths of 4Fr UACs: 100 cm and 70 cm (modified from 100 cm).
RESULTS: PRP was linearly dependent on the height difference from the center of the renal pelvis to the UAC tip for both tested UAC lengths. In our experimental setting, PRP can be reduced by 10 cmH20 simply by lowering the distal tip of a 4 Fr 70 cm UAC positioned alongside the ureteroscope by 19.7 cm. When using a 4 Fr 100 cm UAC, PRP can drop 10 cmH20 by lowering the distal tip of the UAC 23.3 cm below the level of the renal pelvis.
CONCLUSIONS: Implementing the siphoning effect for managing PRP during ureteroscopy could potentially enhance safety and effectiveness.
方法:将9.5Fr一次性输尿管镜插入硅胶肾-输尿管模型,其尖端位于肾盂。通过输尿管镜在肾盂上方100厘米处进行冲洗。一个Y形适配器安装在模型的肾盂端口上,通过每个肢体容纳压力传感器和4Fr输尿管进入导管(UAC)。通过UAC尖端的排水流速测量每次60s。将UAC的远端尖端放置在肾盂中心下方或上方的各种高度处,以产生虹吸效应。所有试验一式三份进行两种长度的4FrUAC:100cm和70cm(从100cm修改)。
结果:对于两种测试的UAC长度,PRP与从肾盂中心到UAC尖端的高度差呈线性关系。在我们的实验环境中,只需将位于输尿管镜旁边的4Fr70cmUAC的远端尖端降低19.7cm,即可将PRP减少10cmH20。使用4Fr100cmUAC时,PRP可以通过将UAC的远端尖端降低到肾盂水平以下23.3cm来降低10cmH20。
结论:在输尿管镜检查期间实施PRP的虹吸效应可能会提高安全性和有效性。