Renal pelvic pressure drives fluid absorption in mini‐percutaneous nephrolithotomy: a quantitative model for absorption rate

IF 3.7 2区医学 Q1 UROLOGY & NEPHROLOGY

BJU International Pub Date : 2025-06-09 DOI:10.1111/bju.16812

Guilin Wang, Luyang Zhang, Qi Jin, Jiangtao Bai, Xiaoran Li, Qiqi He, Wei Shi, Teng Ma, Hui Ding, Zhilong Dong, Yunxin Zhang, Jun Mi, Zhiping Wang

{"title":"Renal pelvic pressure drives fluid absorption in mini‐percutaneous nephrolithotomy: a quantitative model for absorption rate","authors":"Guilin Wang, Luyang Zhang, Qi Jin, Jiangtao Bai, Xiaoran Li, Qiqi He, Wei Shi, Teng Ma, Hui Ding, Zhilong Dong, Yunxin Zhang, Jun Mi, Zhiping Wang","doi":"10.1111/bju.16812","DOIUrl":null,"url":null,"abstract":"ObjectiveTo determine the quantitative impact of renal pelvic pressure (RPP) parameters on irrigation fluid absorption dynamics during mini‐percutaneous nephrolithotomy (mPCNL).Materials and MethodsIn this prospective observational study, 50 patients undergoing mPCNL were enrolled. Continuous synchronised RPP monitoring was performed using a calibrated pressure transduction system, while fluid absorption was quantified via a clinical grade endoscopic surgical monitor. Analytical approaches included Pearson correlation analysis and simple linear regression modelling to characterise pressure absorption dynamics.ResultsThe median (interquartile range [IQR]) baseline, mean and maximum RPP values were 12.0 (10.3–14.8) mmHg, 16.7 (14.6–23.1) mmHg and 60.0 (35.0–67.3) mmHg, respectively. The median (IQR) fluid absorption was 625.5 (270.8–1296.5) mL, corresponding to an absorption rate of 838.0 (385.9–1349.4) mL/h. Mean RPP exhibited a significant positive correlation with absorption rate (Pearson R = 0.54, P < 0.001), with linear regression modelling demonstrating a 54.2‐mL/h increase in absorption rate per 1‐mmHg rise in mean RPP (R2 = 0.29, P < 0.001). Transient RPP spikes exceeding 100 mmHg occurred in 9% of cases, primarily linked to access sheath obstructions from calculus migration or blood clots.ConclusionsThis study presents the first quantitative model identifying mean RPP as a critical predictor of irrigation fluid absorption during mPCNL. Acute pressure surges driven by sheath obstruction underscore the necessity for real‐time RPP monitoring and optimised outflow strategies to minimise absorption‐related risks.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"47 1","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BJU International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/bju.16812","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

ObjectiveTo determine the quantitative impact of renal pelvic pressure (RPP) parameters on irrigation fluid absorption dynamics during mini‐percutaneous nephrolithotomy (mPCNL).Materials and MethodsIn this prospective observational study, 50 patients undergoing mPCNL were enrolled. Continuous synchronised RPP monitoring was performed using a calibrated pressure transduction system, while fluid absorption was quantified via a clinical grade endoscopic surgical monitor. Analytical approaches included Pearson correlation analysis and simple linear regression modelling to characterise pressure absorption dynamics.ResultsThe median (interquartile range [IQR]) baseline, mean and maximum RPP values were 12.0 (10.3–14.8) mmHg, 16.7 (14.6–23.1) mmHg and 60.0 (35.0–67.3) mmHg, respectively. The median (IQR) fluid absorption was 625.5 (270.8–1296.5) mL, corresponding to an absorption rate of 838.0 (385.9–1349.4) mL/h. Mean RPP exhibited a significant positive correlation with absorption rate (Pearson R = 0.54, P < 0.001), with linear regression modelling demonstrating a 54.2‐mL/h increase in absorption rate per 1‐mmHg rise in mean RPP (R2 = 0.29, P < 0.001). Transient RPP spikes exceeding 100 mmHg occurred in 9% of cases, primarily linked to access sheath obstructions from calculus migration or blood clots.ConclusionsThis study presents the first quantitative model identifying mean RPP as a critical predictor of irrigation fluid absorption during mPCNL. Acute pressure surges driven by sheath obstruction underscore the necessity for real‐time RPP monitoring and optimised outflow strategies to minimise absorption‐related risks.

查看原文本刊更多论文

肾盆腔压力驱动小经皮肾镜取石术中的液体吸收：吸收率的定量模型

目的探讨小经皮肾镜取石术（mPCNL）中肾盆腔压（RPP）参数对灌洗液吸收动力学的定量影响。材料和方法在这项前瞻性观察性研究中，纳入了50例接受mPCNL的患者。使用校准的压力传导系统进行连续同步RPP监测，同时通过临床级内窥镜手术监视器量化液体吸收。分析方法包括皮尔逊相关分析和简单的线性回归模型来表征压力吸收动力学。结果基线、平均和最大RPP值中位数（四分位间距[IQR]）分别为12.0 (10.3-14.8)mmHg、16.7 (14.6-23.1)mmHg和60.0 (35.0-67.3)mmHg。液体吸光度中位数（IQR）为625.5 (270.8 ~ 1296.5)mL，吸光度为838.0 (385.9 ~ 1349.4)mL/h。平均RPP与吸收率呈显著正相关(Pearson R = 0.54, P <；0.001)，线性回归模型显示，平均RPP每升高1 mmHg，吸收率增加54.2 mL/h (R2 = 0.29, P <；0.001)。9%的病例出现短暂性RPP峰值超过100 mmHg，主要与结石迁移或血凝块引起的通路鞘阻塞有关。本研究提出了第一个定量模型，确定平均RPP是mPCNL期间灌溉液体吸收的关键预测因子。鞘层阻塞导致的急性压力激增强调了实时RPP监测和优化流出策略的必要性，以最大限度地降低与吸收相关的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

BJU International 医学-泌尿学与肾脏学

CiteScore

9.10

自引率

4.40%

发文量

262

审稿时长

1 months

期刊介绍： BJUI is one of the most highly respected medical journals in the world, with a truly international range of published papers and appeal. Every issue gives invaluable practical information in the form of original articles, reviews, comments, surgical education articles, and translational science articles in the field of urology. BJUI employs topical sections, and is in full colour, making it easier to browse or search for something specific.