Preliminary Evaluation of High Frequency Jet Ventilation in RIRS from a Tertiary Center
Main Article Content
Abstract
Purpose
Retrograde intrarenal surgery (RIRS) is an effective and safe therapeutic option in the treatment of renal stones&upper tract urothelial carcinoma. High frequency jet ventilation (HFJV) is a lung ventilation mode offering a substantial reduction of renal movement. In our pilot study, we evaluated a HFJV ventilatory protocol in endoscopic treatment of renal stones.
Materials and methods
15 consecutive cases of the treatment of renal stones larger than 7mm have been included in our study, with exclusion of patients suffering from severe pulmonary disease. Total intravenous anesthesia has been chosen with intraprocedural HFJV. The intraoperative gas exchange parameters, as well as eventual postoperative respiratory adverse events were taken note of. A laser stone disintegration has been performed in all procedures, including a three-month postoperative follow-up.
Results
Mean duration of HFJV procedure was 56,3 min (35-110), Et CO2(end tidal ; carbon dioxide concentration measured at the end of expiration,the normal values of which are 4-6%) before HFJV - 4,81 % (4,1-5,8) and after HFJV 5,22 % (3,9-7,2) respectively. No signs of respiratory impairment were detected. The operative time ranged between 20- 102 min. The renal movement reduction with HFJV was of significantly noticeable by the surgeon. Three patients were readmitted to the hospital; one of them due to a urinary tract infection. No perioperative pulmonary complications were reported. Conclusion
HFJV is a safe, feasible method that can be used in RIRS and can significantly enhance the efficacy of the procedure. However, further evaluation of the method is needed.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright of articles published in all DPG titles is retained by the author(s). The author(s) grants DPG the rights to publish the article and identify itself as the original publisher. The author grants DPG exclusive commercial rights to the article. The author grants any party the rights to use the article freely for non-commercial purposes provided that the original work is properly cited.
References
2. Whelan, J. P., N. Gravenstein, J. L. Welch, S. Lampotang, R. C. Newman, and B. Finlayson. 1988. “Simulation of Ventilatory-Induced Stone Movement and Its Effect on Stone Fracture during Extracorporeal Shock Wave Lithotripsy.” The Journal of Urology 140 (2):405–7.
3. Cormack, John R., Raymond Hui, David Olive, and Simone Said. 2007. “Comparison of Two Ventilation Techniques during General Anesthesia for Extracorporeal Shock Wave Lithotripsy: High-Frequency Jet Ventilation versus Spontaneous Ventilation with a Laryngeal Mask Airway.” Urology 70 (1):7–10.
4. Froese, A. B., and A. C. Bryan. 1981. “High Frequency Ventilation.” The American Review of Respiratory Disease 123 (3):249–50.
5. Biro, P., D. R. Spahn, and T. Pfammatter. 2009. “High-Frequency Jet Ventilation for Minimizing Breathing-Related Liver Motion during Percutaneous Radiofrequency Ablation of Multiple Hepatic Tumours.” British Journal of Anaesthesia 102 (5):650–53.
6. Abderhalden, Susanne, Peter Biro, Lukas Hechelhammer, Roger Pfiffner, and Thomas Pfammatter. 2011. “CT-Guided Navigation of Percutaneous Hepatic and Renal Radiofrequency Ablation under High-Frequency Jet Ventilation: Feasibility Study.” Journal of Vascular and Interventional Radiology: JVIR 22 (9):1275–78.
7. Engstrand, Jennie, Grzegorz Toporek, Piotr Harbut, Eduard Jonas, Henrik Nilsson, and Jacob Freedman. 2017. “Stereotactic CT-Guided Percutaneous Microwave Ablation of Liver Tumors With the Use of High-Frequency Jet Ventilation: An Accuracy and Procedural Safety Study.” AJR. American Journal of Roentgenology 208 (1):193–200.
8. Freedman, Jacob, and Piotr Harbut. 2016. “Navigated Percutaneous Lung Ablation under High-Frequency Jet Ventilation of a Metastasis from a Wilms’ Tumour: A Paediatric Case Report.” Case Reports in Oncology 9 (2):400–404.
9. Cormack, John R., Raymond Hui, David Olive, and Simone Said. 2007. “Comparison of Two Ventilation Techniques during General Anesthesia for Extracorporeal Shock Wave Lithotripsy: High-Frequency Jet Ventilation versus Spontaneous Ventilation with a Laryngeal Mask Airway.” Urology 70 (1):7–10.
10. Evans, E., P. Biro, and N. Bedforth. 2007. “Jet Ventilation.” Continuing Education in. bjanaesthesia.org. http://bjanaesthesia.org/article/S1743-1816(17)30507-3/fulltext.
11. Emiliani, Esteban, Michele Talso, Mohammed Baghdadi, Sadam Ghanem, Jonathan Golmard, Hugo Pinheiro, Agapios Gkentzis, Salvatore Butticè, and Olivier Traxer. 2016. “The Use of Apnea During Ureteroscopy.” Urology 97 (November):266–68.
12. Gustafsson, I-M, Å. Lodenius, J. Tunelli, J. Ullman, and M. Jonsson Fagerlund. 2017. “Apnoeic Oxygenation in Adults under General Anaesthesia Using Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) - a Physiological Study.” British Journal of Anaesthesia 118 (4):610–17.
13. Hedenstierna, Göran, and Lennart Edmark. 2010. “Mechanisms of Atelectasis in the Perioperative Period.” Best Practice & Research. Clinical Anaesthesiology 24 (2):157–69.