Department of Management and Logistics in Health Care, Medical University of Lodz, 90-647 Lodz, Poland.
Urology Department, Regional Specialized Hospital in Nowa Sól, 67-100 Nowa Sól, Poland.
Int J Environ Res Public Health. 2022 Jan 20;19(3):1114. doi: 10.3390/ijerph19031114.
Retrograde intrarenal surgery (RIRS) is an innovative and effective method of kidney stones treatment, as it had great influence on the development of endoscopy in urology. The increasing prevalence of urolithiasis together with the rapid development of endourology leads to a rise in the number of procedures related to the disease. Flexible ureteroscopy is constantly being improved, especially regarding the effectiveness and safety of the procedure. The purpose of this study is to evaluate intraoperative and early post-operative complications of RIRS in the treatment of kidney stones. A retrospective analysis of medical records was performed. A series was comprised of 207 consecutive operations performed from 2017 to 2020. Complications occurred in 19.3% ( = 40) of patients. Occurrence according to the Clavien-Dindo scale was: 11.1% for grade I, 5.8% for grade II and 2.4% for grade IV. Infectious complications included SIRS (5.3%, = 11) and sepsis (2.4%, = 5). Statistical analysis revealed a correlation between acute post-operative infections and positive midstream urine culture, history of chronic or recurrent urinary tract infections, and increased body mass index (BMI). Furthermore, a significant correlation was observed between pain requiring the use of opioids with BMI over 25. Consequently, history of urinary tract infections, positive pre-operative urine culture, and increased BMI are considered risk factors and require appropriate management.
逆行性肾内手术 (RIRS) 是一种创新性且有效的肾结石治疗方法,因为它对泌尿科内镜的发展产生了重大影响。随着尿石症发病率的增加和腔内泌尿外科的快速发展,与该疾病相关的手术数量也在增加。软性输尿管镜不断得到改进,尤其是在手术的有效性和安全性方面。本研究旨在评估 RIRS 治疗肾结石的术中及早期术后并发症。对病历进行了回顾性分析。该系列包括 2017 年至 2020 年连续进行的 207 例手术。19.3%(=40)的患者发生了并发症。根据 Clavien-Dindo 分级,发生:I 级 11.1%,II 级 5.8%,IV 级 2.4%。感染性并发症包括全身炎症反应综合征 (SIRS,5.3%,=11) 和败血症 (2.4%,=5)。统计分析显示,术后急性感染与中段尿培养阳性、慢性或复发性尿路感染史和体重指数 (BMI) 增加之间存在相关性。此外,疼痛需要使用阿片类药物与 BMI 超过 25 之间也存在显著相关性。因此,尿路感染史、术前尿培养阳性和 BMI 增加被认为是危险因素,需要进行适当的管理。