{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T01:40:51Z","timestamp":1792374051259,"version":"4.4.0"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"abstract":"\n Objectives<\/jats:title>\n To determine whether transient apnoea (TA) during flexible ureteroscopic laser lithotripsy improves active lithotripsy efficiency compared with regular mechanical ventilation (RMV) and small tidal\u2010volume ventilation (STVV).<\/jats:p>\n <\/jats:sec>\n \n Patients and Methods<\/jats:title>\n In this single\u2010centre, three\u2010arm randomised trial, 150 adults with a single computed tomography (CT)\u2010confirmed renal, ureteropelvic, or proximal ureteric stone measuring 10\u2013<20\u2009mm were assigned one\u2010to\u2010one\u2010to\u2010one to RMV, STVV, or TA. TA followed 5\u2010min 100% oxygen pre\u2010oxygenation, with 9\u2010min maximum and pre\u2010specified stopping criteria under continuous anaesthetic monitoring. The primary endpoint was active lithotripsy efficiency, defined as CT\u2010estimated stone volume divided by elapsed active lithotripsy time. Analyses followed the intention\u2010to\u2010treat principle.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The mean (standard deviation) active lithotripsy efficiency was 27.8\u2009(8.9), 26.6\u2009(8.0), and 34.3\u2009(10.0)\u2009mm\n 3<\/jats:sup>\n \/min with RMV, STVV, and TA, respectively (\n P<\/jats:italic>\n \u2009<\u20090.001). TA increased adjusted efficiency by 5.9\u2009mm\n 3<\/jats:sup>\n \/min vs RMV (95% confidence interval [CI] 2.2\u20139.6\u2009mm\n 3<\/jats:sup>\n \/min) and 6.8\u2009mm\n 3<\/jats:sup>\n \/min vs STVV (95% CI 3.3\u201310.2\u2009mm\n 3<\/jats:sup>\n \/min). The median active lithotripsy time was 27.5, 26.5, and 22.0\u2009min (\n P<\/jats:italic>\n \u2009=\u20090.001); total operative time was 50.0, 50.0, and 43.0\u2009min (\n P<\/jats:italic>\n \u2009=\u20090.002); and surgeon\u2010rated targeting stability scores were 7.0, 7.0, and 9.0 (\n P<\/jats:italic>\n \u2009<\u20090.001), respectively. Postoperative Day 1\/1\u2010month stone\u2010free rates were 88%\/92%, 80%\/96%, and 88%\/90%, respectively, with no significant between\u2010group differences. The median (interquartile range) achieved apnoea duration was 5.0\u2009(4.5\u20136.8)\u2009min; 46\/50 resumed ventilation before the 9\u2010min maximum, most commonly for heart\u2010rate decline\/bradycardia (\n n<\/jats:italic>\n \u2009=\u200927) or blood\u2010pressure decline\/hypotension (\n n<\/jats:italic>\n \u2009=\u200920). No patient had a peripheral oxygen saturation <90% or a Clavien\u2013Dindo Grade \u2265III complication; transient hypercapnia and respiratory acidosis improved after ventilation resumed.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Transient apnoea improved lithotripsy efficiency and shortened operative time compared with RMV and STVV, with higher surgeon\u2010rated targeting stability. The benefit was primarily intraoperative, without evidence of greater postoperative stone clearance. Protocolised TA may provide a brief intraoperative motion\u2010control option with pre\u2010oxygenation, continuous anaesthetic monitoring, and individualised termination.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.70505","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T01:16:01Z","timestamp":1792372561000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Transient apnoea for motion control during flexible ureteroscopic lithotripsy: a randomised trial"],"prefix":"10.1111","author":[{"given":"Jiahuan","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Health Management Centre The First Affiliated Hospital of Naval Medical University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology The First Affiliated Hospital of Naval Medical University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7078-8057","authenticated-orcid":false,"given":"Xiaolei","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Naval Medical University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology The First Affiliated Hospital of Naval Medical University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyu","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Naval Medical University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Naval Medical University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaoxiong","family":"Ming","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Naval Medical University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Naval Medical University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2447-8813","authenticated-orcid":false,"given":"Yonghan","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Naval Medical University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanchang","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology The First Affiliated Hospital of Naval Medical University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofeng","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Naval Medical University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6070-1832","authenticated-orcid":false,"given":"Linhui","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Naval Medical University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4546-5189","authenticated-orcid":false,"given":"Ling","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Naval Medical University Shanghai 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