Seike Kensaku, Ishida Takashi, Taniguchi Tomoki, Fujimoto Shota, Kato Daiki, Takai Manabu, Iinuma Koji, Nakane Keita, Uno Hiromi, Tamaki Masayoshi, Komeda Hisao, Koie Takuya
Department of Urology, Chuno Kosei Hospital, Seki 5013802, Japan.
Department of Urology, Gifu Municipal Hospital, Gifu 5008513, Japan.
Medicina (Kaunas). 2021 Oct 13;57(10):1100. doi: 10.3390/medicina57101100.
: In this study, we aimed to evaluate predictive factors of postoperative fever (POF) after ureterorenoscopic lithotripsy (URSL). A total of 594 consecutive patients who underwent URSL for urinary stone disease at Gifu Municipal Hospital and Chuno Kosei Hospital between April 2016 and January 2021 were enrolled in this study. In all patients, antibiotics were routinely administered intraoperatively and the next day after surgery. We used rigid and/or flexible ureterorenoscopes depending on the stone location for URSL. Stones were fragmented using a holmium: YAG laser. The fragments of the stone were manually removed as much as possible using a stone basket catheter. A ureteral stent was placed at the end of the surgery in all cases. The median age and body mass index (BMI) in all patients were 62 years and 23.8 kg/m, respectively. The median operation duration was 52 min. The most common URSL-related complication was POF in 28 (4.7%) patients. In these patients, the rates of antibiotic administration and ureteral stent insertion before surgery were significantly higher than in those without POF. In multivariate analysis, BMI was associated with POF after URSL. There were no significant differences in predicting POF after surgery in patients who had bacteriuria or received antibiotics before surgery. A low BMI was significantly associated with POF after URS or URSL.
在本研究中，我们旨在评估输尿管镜碎石术（URSL）后术后发热（POF）的预测因素。2016年4月至2021年1月期间，共有594例在岐阜市立医院和中野光生医院因尿路结石疾病接受URSL的连续患者纳入本研究。所有患者术中及术后次日均常规使用抗生素。根据结石位置，我们使用硬性和/或软性输尿管镜进行URSL。使用钬：钇铝石榴石激光粉碎结石。尽可能使用结石篮导管手动取出结石碎片。所有病例在手术结束时均放置输尿管支架。所有患者的中位年龄和体重指数（BMI）分别为62岁和23.8kg/m²。中位手术时间为52分钟。最常见的与URSL相关的并发症是28例（4.7%）患者出现POF。在这些患者中，术前抗生素使用和输尿管支架置入率显著高于无POF的患者。多因素分析显示，BMI与URSL后POF相关。术前有菌尿或接受抗生素治疗的患者术后预测POF无显著差异。低BMI与输尿管镜检查（URS）或URSL后POF显著相关。
