Background and Aims: Robotic flexible ureteroscopy often requires intermittent apnoeic periods to minimise kidney movement and improve surgical conditions. This study evaluated the effectiveness of high-flow oxygenation (HFO) in maintaining oxygenation and preventing desaturation during retrograde flexible ureteroscopy (RFU). Methods: This retrospective cohort study included 62 male patients undergoing robotic RFU: 28 received HFO and 34 served as controls. The HFO group underwent repeated 5-minute apnoeic periods with 100% oxygen delivered at up to 80 L/min. Vital parameters were recorded before and after each apnoeic period. In the control group, the tidal volume was reduced to 250 mL with a respiratory rate of 20 cycles per minute during the robotic phase, and these settings were maintained throughout. Wilcoxon rank-sum test, T-tests, and Fisher’s exact test were used to compare the groups. Durbin–Conover test was used for pairwise comparisons. Results: Compared to the HFO group, overall, the control group had slightly higher median end-tidal carbon dioxide (EtCO2) levels (43.3 vs 41.6, P = 0.021), heart rate (71.6 vs 65.1, P = 0.001), mean arterial pressure (83 vs 70.6, P < 0.001), and temperature (36.5 vs 35.6, P < 0.001). No desaturation events or haemodynamic instability occurred in the HFO group. ORI and PI remained stable, and no postoperative complications were reported. Conclusion: HFO during robotic ureteroscopy appears effective in maintaining oxygenation and haemodynamic stability while providing a still surgical field. These findings support its integration into clinical practice for procedures requiring controlled apnoea.
Saraçoğlu et al. (Sun,) studied this question.