Can we identify the risk factors for SIRS/sepsis after percutaneous nephrolithotomy? A meta‑analysis and literature review

Puia, Dragoş; Gheorghincă, Ştefan; Rădăvoi, George Daniel; Jinga, Viorel; Pricop, Cătălin

doi:10.3892/etm.2023.11809

Cited by 4 publications

(1 citation statement)

References 54 publications

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“…Percutaneous nephrolithotomy has the advantages of e cient and rapid stone extraction and high stone removal rate, but there is a risk of serious complications such as haemorrhage, pneumothorax, infection and adjacent organ damage. 10 Ureteroscopy via the natural channel is relatively safe and has become one of the most important means of treating upper urinary tract stones. Hyams et al reported a high SFR of 83% with exible ureteroscopy for renal stones ≤ 2 cm.…”

Section: Discussionmentioning

confidence: 99%

The Safety and Efficacy of Sotn ureteroscopy for Renal and Upper Ureteral Calculi: A Prospective Multicenter Randomized Controlled Trial

Guo

Wang

Weng

et al. 2023

Preprint

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Purpose Sotn ureteroscopy is a new lithotripsy procedure developed on the basis of ureteroscopy and includes a rigid ureteral access sheath, standard mirror, lithotripsy mirror, and Sotn perfusion aspirator. Thus, we performed a prospective multicenter randomized controlled trial comparing the safety and efficacy of Sotn ureteroscopy in the treatment of renal and upper ureteral calculi. Materials and Methods 224 patients with renal and upper ureteral calculi were randomly divided equally into study and control groups from March 2018 to March 2022. All of the patients were approved by the hospital ethics committee (proof number: ZF-2018-164-01 and ZF-2018-165-01) of the Second Affiliate Hospital of Guangzhou University of Chinese Medicine in China. The primary outcome was stone-free rate (SFR) assessed by computed tomography on the 1st day and month after treatment and operation duration. The secondary outcome was postoperative complication rate. Results In total, for upper ureteral calculi, the SFR of 1 day after operation of the Sotn ureteroscopy group was significantly higher than the rigid ureteroscopy group (83.6% vs. 60%, P = 0.006). Moreover, operative time (33.7 ± 1.80 vs. 52.9 ± 2.73 min, P < 0.005) of the Sotn ureteroscopy group was significantly lower than the rigid ureteroscopy group. Additionally, the SFR of 1 day after operation and operative time for the study group (Sotn ureteroscopy combined with flexible ureteroscopy) and the control group (flexible ureteroscopy alone) were 63.2% and 36.8% (P = 0.005), 65.6 ± 4.06 and 80.3 ± 4.91 (P = 0.023), respectively. However, there were no significant differences in the SFR of 1 month after operation, success rate of ureteral access sheath placement, and postoperative complications between the two groups (P > 0.05). In subgroups with stone diameters ≥ 1.5 cm and stone CT values ≥ 1,000 Hounsfield units, Sotn ureteroscopy showed more advantages in terms of the SFR of 1 day after operation. Importantly, complications such as ureteral injury, sepsis, fever and severe haematuria were not statistically different between the two groups (P > 0.05). Conclusions For renal and upper ureteral calculi, Sotn ureteroscopy has the advantage of a higher SFR of 1 day after the operation, a shorter operative time and low complication rates, suggesting that the Sotn ureteroscopy may have further potential applications in clinics.

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Section: Discussionmentioning

confidence: 99%

The Safety and Efficacy of Sotn ureteroscopy for Renal and Upper Ureteral Calculi: A Prospective Multicenter Randomized Controlled Trial

Guo

Wang

Weng

et al. 2023

Preprint

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Association between urinary lithiasis, other than struvite by crystallography and non-ureolytic bacteria

da Cruz Machado,

Miguel Renteria,

Medeiros do Nascimento

et al. 2024

Urolithiasis

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Vacuum-assisted mini-percutaneous nephrolithotomy is associated with lower rates of infectious complications compared to vacuum-cleaner procedure in patients at high risk for infections: a single-center experience

Marmiroli,

Nizzardo,

Zanetti

et al. 2024

World J Urol

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Purpose To evaluate the impact of vacuum-assisted mini-percutaneous nephrolithotomy (vamPCNL) vs. vacuum-cleaner mPCNL (vcmPCNL) on the rate of postoperative infectious complications in a cohort of patients with high risk factors for infections. Methods We retrospectively analysed data from 145 patients who underwent mPCNL between 01/2016 and 12/2022. Patient’s demographics, stones characteristics and operative data were collected. vamPCNL and vcmPCNL were performed based on the surgeon’s preference. High-risk patients were defied as having ≥ 2 predisposing factors for infections such as a history of previous urinary tract infections, positive urine culture before surgery, stone diameter ≥ 3 cm, diabetes mellitus and hydronephrosis. Complications were graded according to modified Clavien classification. Descriptive statistics and logistic regression models were used to identify factors associated with postoperative infectious complications. Results vamPCNL and vcmPCNL were performed in 94 (64.8%) and 51 (35.2%) cases, respectively. After surgery, infectious complications occurred in 43 (29.7%) participants. Patients who developed infectious complications had larger stone volume (p = 0.02) and higher rate of multiple stones (p = 0.01) than those who did not. Infectious complications occurred more frequently after vcmPCNL than vamPCNL (55.9% vs. 44.1%. p = 0.01) in high-risk patients. Longer operative time (p < 0.01) and length of stay (p < 0.01) were observed in cases with infectious complications. At multivariable logistic regression analysis, longer operative time (OR 1.1, p = 0.02) and vcmPCNL (OR 3.1, p = 0.03) procedures were independently associated with the risk of infectious complications post mPCNL, after accounting for stone volume. Conclusion One out of three high-risk patients showed infectious complications after mPCNL. vamPCL and shorter operative time were independent protective factors for infections after surgery.

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Can we identify the risk factors for SIRS/sepsis after percutaneous nephrolithotomy? A meta‑analysis and literature review

Cited by 4 publications

References 54 publications

The Safety and Efficacy of Sotn ureteroscopy for Renal and Upper Ureteral Calculi: A Prospective Multicenter Randomized Controlled Trial

The Safety and Efficacy of Sotn ureteroscopy for Renal and Upper Ureteral Calculi: A Prospective Multicenter Randomized Controlled Trial

Association between urinary lithiasis, other than struvite by crystallography and non-ureolytic bacteria

Vacuum-assisted mini-percutaneous nephrolithotomy is associated with lower rates of infectious complications compared to vacuum-cleaner procedure in patients at high risk for infections: a single-center experience

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