Kidney Stone, Perioperative/Postoperative Complications
Conditions
Keywords
RIRS, Kidney Stone, Single lung ventilation, Simultaneous normal ventilation
Brief summary
In patients undergoing RIRS for kidney stone, we aim to show the effect of single lung ventilation with a double lumen tube on operative (operation scope duration, perforation, hemorrhage, etc. complications) and postoperative parameters (stone-free rates, complications like postoperative hemorrhage and fever, hospital stay, etc.) and to show changes in renal stone position during simultaneous normal ventilation and single lung ventilation.
Detailed description
In recent years open surgical treatment has changed to minimal invasive treatments for kidney stone treatment. Additionally, the treatment choices vary depending on the localization of the stone and its dimensions. In the European Urology Association (EUA) guidelines, it states the RIRS method can be used to treat stones up to 2 cm in the kidney. Due to RIRS the operation and scopy durations and hospital stay have clearly reduced compared to the standard treatment of percutaneous nephrolithotomy. However, the high hydrostatic pressure applied to the renal pelvis during RIRS may cause unwanted results in the postoperative period such as hydronephrosis and loss of renal parenchyma. During the operation, the stone may move during deep inspirium and expirium sequences linked to deep ventilation which may lengthen the operation and scope durations and brings risks such as perforation during laser lithotripsy application. In this study we aimed to apply single lung ventilation during the operation (one of the indications for single lung ventilation is to increase surgical view and ease manipulation) to minimize renal movement on that side and reduce peroperative and postoperative complications.
Interventions
DIAGNOSTIC_TESTPreoperative Parameters
Preoperative Hmg and serum creatinine levels
OTHERPeroperative Parameters
Scope duration, perforation, hemorrhage, etc. complications
OTHERPostoperative Parameters
Stone-free rates, complications like postoperative hemorrhage and fever, hospital stay, etc
OTHERMovement of kidney
Changes in renal stone position during simultaneous normal ventilation and single lung ventilation.
PROCEDUREsingle lung ventilation
Patients in this group will intubated with an endotracheal tube and then a bronchial blocker will be placed with the help of a fiberoptic bronchoscope or will be intubated with a double lumen endobronchial tube. One lung ventilation will be applied
PROCEDUREstandard ventilation
Patients in this group will be intubated with standart single lumen endotracheal tubes and standart two lung ventilation will be applied.
Sponsors
Kahramanmaras Sutcu Imam University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Older than 18 years 2. ASA (American Society of Anesthesiologists) 1-3 3. Patients with 2-3 cm stones in kidneys
Exclusion criteria
1. Patients with staghorn stones in kidneys 2. Patients with urinary system anomalies Removal Criteria : 1. Difficult airway 2. Patients with carinal, bronchial lesions 3. Patients with bad general situation 4. Patients younger than 18 years 5. Satiated patients
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Changes in renal stone position during ventilation | 1-2 Hours | During the operation, the stone may move during deep inspirium and expirium sequences linked to deep ventilation which may lengthen the operation. Preoperative and postoperative Scope will be used to evolve the renal movement. The values will be recorded in milimeters by comparing it. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Scope duration | 10-30 Seconds | Movement of the kidney during the procedure may cause peroperative complications and lengthen operation and scope durations. |
| Total anesthesia duration | 1-2 Hours | Movement of the kidney during the procedure may cause peroperative complications and lengthen operation and scope durations. |
| Hospital stay | 1-3 Days | During the operation, the stone may move during deep inspirium and expirium sequences linked to deep ventilation which may lengthen the operation and scope durations and brings risks such as perforation during laser lithotripsy application. It may effect hospital stay duration. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Perop-postop complications | 1-2 Days | Single lung ventilation during the operation (one of the indications for single lung ventilation is to increase surgical view and ease manipulation) to minimize renal movement on that side and reduce peroperative and postoperative complications. |
Countries
Turkey (Türkiye)
Contacts
Primary ContactÖmer Faruk Boran
Outcome results
None listed