Systemic Inflammatory Response Syndrome After Flexible Ureteroscopic Lithotripsy: A Study of Risk Factors

Zhong, Wen; Leto, Gioacchino; Wang, Liang; Zeng, Guohua

doi:10.1089/end.2014.0409

Cited by 132 publications

(71 citation statements)

References 20 publications

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“…Our finding that there is no correlation between the spreading of bacteria into the irrigation fluid and the development of symptomatic infectious complications after procedure extends our comprehension of the pathogenesis of infectious complications after RIRS. Tokas et al [21] highlighted the role of irrigation volume and irrigation flow rate as independent risk factors for SIRS after RIRS [22]. Moreover, increasing the irrigation volume is correlated with an increase in intrarenal pressures and a subsequent increased risk of infectious complications.…”

Section: Results Compared With Previous Studiesmentioning

confidence: 99%

Infectious Complications After Laser Vaporization of Urinary Stones During Retrograde Intrarenal Surgery Are Not Associated with Spreading of Bacteria into Irrigation Fluid but with Previous Use of Fluoroquinolones

Cai

Cocci

Coccarelli

et al. 2021

European Urology Focus

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Background: The pathogenesis of infectious complications after retrograde intrarenal surgery (RIRS) is not fully understood. Objective: To evaluate spreading of bacteria into irrigation fluid and blood during RIRS for stone management and to correlate such spreading with infectious complications. Design, setting, and participants: From January to December 2017, 38 patients who underwent RIRS for stones in two urological units were enrolled in this prospective, longitudinal cohort study. Intervention: A urine culture was taken before surgery and antimicrobial prophylaxis was given in line with the European Association of Urology guidelines. Blood and irrigation fluid samples were collected at the start of the endoscopic procedure and every 30 min during the procedure. All samples were microbiologically examined and findings were compared with clinical data. Outcome measurements and statistical analyses: Symptomatic and asymptomatic urinary tract infectious complications were correlated with microbiological and clinical data, using Student t test or Mann-Whitney U test. Results and limitations: Ten patients showed significant bacterial growth in irrigation fluid samples (seven Escherichia coli, two Klebsiella pneumoniae, and one Pseudomonas aeruginosa). Eight patients (21%) got febrile urinary tract infections during hospital stay: two had bacterial growth in the irrigation fluid (25%) and one also had bacteremia (12.5%). No correlation was found either between the bacterial growth in the irrigation fluid samples and the urine cultures that were taken before the procedure, or between the bacterial growth in the irrigation fluid samples and the development of postoperative infectious complications. Previous use of fluoroquinolones and a history of urinary tract infections were associated with infectious complications after RIRS.

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Section: Results Compared With Previous Studiesmentioning

confidence: 99%

Infectious Complications After Laser Vaporization of Urinary Stones During Retrograde Intrarenal Surgery Are Not Associated with Spreading of Bacteria into Irrigation Fluid but with Previous Use of Fluoroquinolones

Cai

Cocci

Coccarelli

et al. 2021

European Urology Focus

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“…Second, how to reduce the incidence of postoperative infectious. Zhong [25] found that the length of lithotripsy be well controlled in patients with large stone burden and struvite calculi. Additionally, how to set holmium laser lithotripsy energy size during surgery.…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal shock wave lithotripsy versus retrograde intrarenal surgery for treatment for renal stones 1–2 cm: a meta-analysis

et al. 2015

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This study is to evaluate the efficacy and safety of extracorporeal shock wave lithotripsy (ESWL) versus retrograde intrarenal surgery (RIRS) for the treatment for renal calculi 1-2 cm. PubMed, Embase, the Cochrane Central Register of Controlled Trials, and the Chinese Biomedical Literature Database were researched and hand-searched for relevant congress abstracts and journals about RIRS and ESWL for the treatment for 1- to 2-cm renal stones. The retrieval time ended in September 2014. The related trials met the inclusion criteria were included in the meta-analysis. Two reviewers independently assessed the quality of all included studies, and meta-analysis was performed with RevMan 5.2. Seven literatures were retrieved, including 983 patients. The meta-analysis results showed that, compared to RIRS group, the patients in ESWL group had the following features:(1) the stone-free rate [relative risk (RR) 0.86; 95% confidence interval (CI) 0.77-0.95, P = 0.005] was significantly different between two groups; (2) The retreatment rate of RIRS group was lower (RR 8.12; 95% CI 4.77-13.83, P < 0.00); (3) The complications were not significantly different between two groups (Grade I RR 1.06; 95% CI 0.67-1.69, P = 0.80; Grade II RR 0.75; 95% CI 0.29-1.91, P = 0.54; Grade III RR 0.86; 95% CI 0.26-2.86, P = 0.80). Compared to ESWL, our results showed that RIRS provided significantly higher stone-free rate and lower retreatment rate and without increase in the incidence of complications. However, further randomized trials are needed to confirm these findings.

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“…Sepsis is a systemic inflammatory response syndrome caused by infection, which often occurs after severe trauma, burn and major surgery, leading to multiple organ dysfunction syndrome and even death due to uncontrollable inflammation 1 . The incidence rate of sepsis is high, and the treatment outcomes are unsatisfactory 2 . Over 18 million patients with severe sepsis worldwide each year usually die from related complications.…”

Section: Introductionmentioning

confidence: 99%

Protective effects of resveratrol on acute kidney injury in rats with sepsis

Luo

Liu

et al. 2020

BIOMED PAP

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Aim. To evaluate the protective effects of resveratrol on acute kidney injury (AKI) in septic rats. Methods. A septic rat model was established by cecal ligation and puncture (CLP). A total of 108 male Sprague Dawley rats were randomly divided into an observation group, a 6 h resveratrol intervention group and a 12 h resveratrol intervention group. Then each group was subdivided into Sham, Sham + Res, CLP and CLP + Res groups. After surgery, the survival and morphological changes in kidney tissues were observed. Serum creatinine and urea nitrogen levels, expression of GRP78, BiP, IRE1 and p65 in kidney tissues, and serum levels of TNF-α, IL-1β, IL-6 and IL-10 were investigated. Results. The survival rate of CLP + Res group (75.00%) significantly exceeded that of the CLP group (41.67%) (P<0.05). At postoperative 12 h, resveratrol significantly decreased serum creatinine and urea nitrogen levels (P<0.05). Resveratrol evidently relieved renal tubular swelling and luminal narrowing in CLP rats, and significantly reduced the high expressions of GRP78, BiP, phosphorylated IRE1 and p65 proteins (P<0.05). P65 was mainly located in the cytoplasm of Sham, Sham + Res and CLP + Res groups, and in the nucleus of the CLP group. At postoperative 12 h, resveratrol significantly reduced serum levels TNF-α, IL-1β and IL-6 in CLP rats (P<0.05), whereas elevated that of IL-10 (P<0.05). Conclusion. Resveratrol significantly decreased the mortality rate of septic rats and alleviated AKI, probably by attenuating endoplasmic reticulum stress, inhibiting activation of the NF-κB pathway and mitigating the inflammatory response.

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Systemic Inflammatory Response Syndrome After Flexible Ureteroscopic Lithotripsy: A Study of Risk Factors

Cited by 132 publications

References 20 publications

Infectious Complications After Laser Vaporization of Urinary Stones During Retrograde Intrarenal Surgery Are Not Associated with Spreading of Bacteria into Irrigation Fluid but with Previous Use of Fluoroquinolones

Infectious Complications After Laser Vaporization of Urinary Stones During Retrograde Intrarenal Surgery Are Not Associated with Spreading of Bacteria into Irrigation Fluid but with Previous Use of Fluoroquinolones

Extracorporeal shock wave lithotripsy versus retrograde intrarenal surgery for treatment for renal stones 1–2 cm: a meta-analysis

Protective effects of resveratrol on acute kidney injury in rats with sepsis

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