Risk factors of systemic inflammation response syndrome after endoscopic combined intrarenal surgery in the modified Valdivia position

Tabei, Tadashi; Ito, Hiroki; Usui, Kimitsugu; Kuroda, Shinnosuke; Kawahara, Takashi; Terao, Hideyuki; Fujikawa, Atsushi; Makiyama, Kazuhide; Yao, Masahiro; Matsuzaki, Junichi

doi:10.1111/iju.13124

Cited by 13 publications

(9 citation statements)

References 32 publications

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“…Tabei et al speculated that this discrepancy might be explained by the lower intrarenal pressures obtained by simultaneous ureteroscopy (and the presence of the ureteral access sheath they insert). 2 We totally agree, also considering the significantly higher septic shock rates of the miniaturized percutaneous approaches (small tracts in the absence of an adequate irrigation out flow). 5 Therefore, the combination of PCNL with retrograde ureteroscopy in ECIRS does not imply the sum of the two infectious risks, with the retrograde one being rather low (1-10%) but possibly life-threatening if not treated in a timely manner or if underestimated.…”

supporting

confidence: 58%

“…Tabei et al . speculated that this discrepancy might be explained by the lower intrarenal pressures obtained by simultaneous ureteroscopy (and the presence of the ureteral access sheath they insert) . We totally agree, also considering the significantly higher septic shock rates of the miniaturized percutaneous approaches (small tracts in the absence of an adequate irrigation out flow) …”

supporting

confidence: 52%

“…Tabei et al . mentioned the known risk factors (female sex, diabetes, staghorn calculi, prior PCNL, positive preoperative urinary culture, preoperative use of a nephrostomy tube, operation time), adding for endoscopic combined intrarenal surgery (ECIRS) >4 involved calyces, >500 mm 2 stone surface area and a history of febrile urinary tract infection …”

mentioning

confidence: 99%

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Editorial Comment to Risk factors of systemic inflammation response syndrome after endoscopic combined intrarenal surgery in the modified Valdivia position

Scoffone¹,

Cracco²

2016

Int J of Urology

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supporting

confidence: 58%

supporting

confidence: 52%

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Editorial Comment to Risk factors of systemic inflammation response syndrome after endoscopic combined intrarenal surgery in the modified Valdivia position

Scoffone¹,

Cracco²

2016

Int J of Urology

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“…In a previous study of 370 ECIRS cases, a history of febrile UTI increased the risk of sepsis. 25 Therefore, the prevention of postoperative febrile UTI is important to achieve better outcomes following ECIRS.…”

Section: Discussionmentioning

confidence: 99%

Ureteroscopy‐assisted puncture for ultrasonography‐guided renal access significantly improves overall treatment outcomes in endoscopic combined intrarenal surgery

et al. 2021

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Objectives: To assess the impact and availability of ureteroscopy-assisted puncture for percutaneous renal access during ultrasonography-guided miniaturized (mini)-endoscopic combined intrarenal surgery for large volume renal and/or proximal ureteral stones. Methods: We conducted a multi-institutional retrospective cohort study for urolithiasis treatment. Data from a total of 313 patients who underwent mini-endoscopic combined intrarenal surgery to treat renal and/or ureteral stones between January 2016 and April 2020 were collected. We compared the outcomes between ultrasonography-guided miniendoscopic combined intrarenal surgery with and without ureteroscopy-assisted puncture (ureteroscopy-assisted puncture(+) group [n = 126] and ureteroscopy-assisted puncture(À) group [n = 187] group, respectively). The primary outcome was requirement for additional surgical intervention. Secondary outcomes were stone-free rate, complications and total procedure, fluoroscopy, hospital stay, and postoperative ureteral stent placement durations. Results: The ureteroscopy-assisted puncture(+) group had a lower additional surgical intervention rate and a higher stone-free rate immediately after and 3 months after surgery than the ureteroscopy-assisted puncture(À) group (5.6% vs 19.7%, P < 0.001; 82.5% vs 65.8%, P = 0.001; 59.5% vs 44.6%, P = 0.011). The median total procedure, fluoroscopy, and postoperative ureteral stent placement durations were 18 min, 3 min, and 5 days shorter, respectively, in the ureteroscopy-assisted puncture(+) group. Multivariate analyses showed that ureteroscopy-assisted puncture was associated with a decreased risk of additional surgical intervention (odds ratio 0.31, P = 0.011) and postoperative infection (odds ratio 0.34, P = 0.003) and decreased total procedure (estimate = À11 min; P = 0.011), fluoroscopy (estimate = À3 min; P = 0.034), and postoperative ureteral stent placement (estimate = À8 days; P = 0.011) durations. Female patients and those with smaller stone volumes or without hydronephrosis were identified as ideal ureteroscopy-assisted puncture candidates. Conclusions: Ureteroscopy-assisted puncture during mini-endoscopic combined intrarenal surgery could provide favorable surgical outcomes, especially in female patients without collecting system obstruction.

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“…However, severe postoperative infections can occur with ECIRS, such as those with PCNL and URS. 6 In the guidelines published by the Japanese Urological Association, 7 BL inhibitor-containing penicillin, firstand second-generation cephalosporins, and aminoglycosides are recommended for URS and PCNL. There is still no mention of ECIRS in the European Association of Urology, the American Urological Association, and the Japanese Urological Association guidelines.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of fosfomycin in preventing infection after endoscopic combined intrarenal surgery in periods of limited supply of first‐ and second‐generation cephalosporins

et al. 2022

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Objectives In March 2019, cefazolin was unavailable owing to difficulty in procuring the active ingredient. Furthermore, the supply of alternative drugs, such as cefotiam and cefmetazole, was limited. In the Department of Nephro‐Urology, fosfomycin‐based drugs are used as substitutes for cefazolin, which is a perioperative prophylactic antibacterial drug. Herein, we investigated the effectiveness of fosfomycin sodium and cefotiam in preventing infection after endoscopic combined intrarenal surgery as a retrospective preliminary study. Methods A total of 200 patients who underwent endoscopic combined intrarenal surgery at our department between August 2017 and January 2021 were included. The patients were administered cefotiam (n = 95) or fosfomycin (n = 105) as perioperative antibacterial agents. There were no significant differences in the median age or surgery time between the cefotiam and fosfomycin groups. Propensity score matching was performed to match the preoperative urine bacterial counts of both groups. Sixty‐eight patients were selected from each group. Results The median postoperative hospital stay duration was 4 days for the two groups. The median maximum postoperative temperatures were 37.5 and 37.4°C, respectively. There were no significant differences between the maximum postoperative temperatures in both groups. Furthermore, there were no differences between the groups regarding the white blood cell counts, C‐reactive protein levels, and aspartate aminotransferase and alanine aminotransferase levels postoperatively, as well as in terms of postoperative fever requiring additional antibiotics. Conclusions During a period of difficulty in acquiring cefazolin and cefotiam, the use of fosfomycin allowed us to continue with the procedure without increased clinical complications.

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Risk factors of systemic inflammation response syndrome after endoscopic combined intrarenal surgery in the modified Valdivia position

Cited by 13 publications

References 32 publications

Editorial Comment to Risk factors of systemic inflammation response syndrome after endoscopic combined intrarenal surgery in the modified Valdivia position

Editorial Comment to Risk factors of systemic inflammation response syndrome after endoscopic combined intrarenal surgery in the modified Valdivia position

Ureteroscopy‐assisted puncture for ultrasonography‐guided renal access significantly improves overall treatment outcomes in endoscopic combined intrarenal surgery

Efficacy of fosfomycin in preventing infection after endoscopic combined intrarenal surgery in periods of limited supply of first‐ and second‐generation cephalosporins

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