Higher lasing efficiency in Flexible ureteroscopy and laser lithotripsy may lower rates of postoperative complications

Anesthesia Method: Patients who received endotracheal intubation (ETT) had significantly higher lasing efficiency (78.7%) compared to those who had a laryngeal mask airway (LMA) (73.3%). This difference was observed in both univariate and multivariate analyses, even after adjusting for stone size, stone number, stone density, and patient BMI.

Complications: Patients with higher lasing efficiency also experienced significantly lower rates of postoperative complications. Those with no postoperative complications had a mean lasing efficiency of 76.3%, while those with any grade (I-V) Clavien-Dindo complication within 30 days after surgery had a mean efficiency of 70.0%.

The study suggests that flexible ureteroscopy and laser lithotripsy cases with higher lasing efficiency are associated with lower rates of postoperative complications. Additionally, the data indicates that using endotracheal intubation (ETT) for anesthesia may improve overall lasing efficiency, although the choice of anesthesia administration remains one of several factors to consider.

These findings contribute to a better understanding of the factors influencing the success of kidney stone treatments using holmium laser lithotripsy. They underscore the importance of optimizing surgical techniques and anesthesia methods to enhance patient outcomes and minimize complications during these procedures.

Reference:

Gelikman, D. G., Ibanez, K. R., Reed, A. M., Hsi, R., Nimmagadda, N., & Miller, N. Factors affecting holmium laser efficiency: Comparison of laryngeal mask airway and endotracheal intubation during ureteroscopy for renal stones. Journal of Endourology,2023. https://doi.org/10.1089/end.2023.0294