This randomized clinical trial will compare four ventilation strategies during retrograde intrarenal surgery performed under general anesthesia. The study aims to determine whether reducing respiratory-related kidney movement improves surgical success and decreases perioperative complications. Eighty adult patients will be randomly assigned to standard ventilation, hypoventilation, intermittent apnea ventilation, or one-lung ventilation. Surgical outcomes and perioperative complications will be compared between groups.
Retrograde intrarenal surgery is commonly performed under general anesthesia, but respiratory movement may interfere with kidney stability during the procedure. This prospective, randomized, single-center trial will compare standard ventilation, hypoventilation, intermittent apnea ventilation, and one-lung ventilation in adult patients undergoing retrograde intrarenal surgery. The primary objective is to determine whether different ventilation strategies improve surgical success by reducing kidney movement. Secondary outcomes include operative time, stone access time, fluoroscopy time, laser use time, complications, length of hospital stay, and postoperative stone-free rate.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
80
Volume-controlled mechanical ventilation using standard ventilator settings during general anesthesia.
Volume-controlled mechanical ventilation using reduced tidal volume and respiratory rate during general anesthesia.
Intermittent apnea periods applied during selected stages of retrograde intrarenal surgery to reduce kidney motion.
One-lung ventilation applied during selected stages of retrograde intrarenal surgery to reduce kidney motion.
Sultan Abdulhamid Han Training and Research Hospital
Istanbul, Istanbul, Turkey (Türkiye)
Kidney Motion During Retrograde Intrarenal Surgery
Kidney motion during surgery will be evaluated and compared among the four ventilation strategies.
Time frame: During surgery
Stone-free Rate
Percentage of patients who are stone-free after retrograde intrarenal surgery.
Time frame: Postoperative Day 30
Operative Time
Total duration of surgery measured from the beginning to the end of the surgical procedure.
Time frame: During surgery
Fluoroscopy Time
Total fluoroscopy exposure time recorded during the procedure.
Time frame: During surgery
Laser Activation Time
Total duration of laser use during stone fragmentation.
Time frame: During surgery
Perioperative Complications
Occurrence of intraoperative and postoperative complications.
Time frame: Periprocedural
Length of Hospital Stay
Number of days of hospitalization.
Time frame: Periprocedural
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