Department of Urology, Zhuzhou Central Hospital, 116# South Changjiang Road, Tianyuan district, Zhuzhou, 412007, Hunan, China.
Department of Radiology, Shaanxi Provincial People's Hospital, No. 256 Youyi Road, Xi'an, 710068, Shaanxi, China.
Urolithiasis. 2018 Apr;46(2):197-202. doi: 10.1007/s00240-017-0961-6. Epub 2017 Feb 24.
The increase in the retrograde intrarenal surgery (RIRS) has been accompanied by the increase in complications. This study identified the factors that affected the severity of the complications using the modified Clavien classification system (MCCS). Three hundred and twenty-two consecutive RIRS performed by a single surgeon were analyzed. Data collection included demographics, clinical parameters, and perioperative and postoperative complications. The rate of adverse events for each of the Clavien grades was calculated, and statistical comparisons were made. The impact of each of the factors on the severity of the complications, based on the MCCS, was investigated using the univariate and multivariate analyses. The total complication rate was 26.1% (MCCS: I = 67.7%, II = 22.7%, IIIb = 7.2%, IVb = 2.4%). On the univariate analyses, the following factors affected complication: positive preoperative urine culture, operative time, irrigation rate, and stone burden. Multivariate logistic regression analysis demonstrated that positive preoperative urine culture, irrigation rate, and operative time were the significant factors affecting the complications. Most of the RIRS complications were in the lower Clavien grades and major complications were uncommon. Positive preoperative urine culture, irrigation rate, and operative time were the factors that affected complications.
逆行性肾内手术(RIRS)的增加伴随着并发症的增加。本研究使用改良 Clavien 分类系统(MCCS)确定了影响并发症严重程度的因素。对一名外科医生连续进行的 322 例 RIRS 进行了分析。数据收集包括人口统计学、临床参数以及围手术期和术后并发症。计算了每个 Clavien 等级的不良事件发生率,并进行了统计学比较。使用单因素和多因素分析研究了基于 MCCS 的每个因素对并发症严重程度的影响。总并发症发生率为 26.1%(MCCS:I=67.7%,II=22.7%,IIIb=7.2%,IVb=2.4%)。单因素分析表明,以下因素影响并发症:术前尿液培养阳性、手术时间、冲洗率和结石负荷。多因素 logistic 回归分析表明,术前尿液培养阳性、冲洗率和手术时间是影响并发症的显著因素。大多数 RIRS 并发症处于较低的 Clavien 等级,严重并发症并不常见。术前尿液培养阳性、冲洗率和手术时间是影响并发症的因素。