Demirelli Erhan, Öğreden Ercan, Bayraktar Cemil, Tosun Alptekin, Oğuz Ural
Giresun University, Faculty of Medicine, Department of Urology, Giresun, Turkey.
Ministry of Health, Kayseri City Hospital, Department of Urology, Kayseri, Turkey.
Asian J Urol. 2022 Jul;9(3):307-312. doi: 10.1016/j.ajur.2021.11.006. Epub 2021 Nov 20.
Perirenal fat stranding (PFS) is linear areas of soft-tissue attenuation in the perirenal space on non-contrast computed tomography. The present study aimed to investigate whether PFS is associated with infectious complications after ureterorenoscopy (URS) in patients with ureteral calculi in any location.
The data of 602 patients with ureteral stones who underwent URS were analyzed retrospectively. The patients were divided into two groups as Group 1 (PFS not detected) and Group 2 (PFS detected). Gender, and age of patients, size, side, and location of the stone, operation time, double-J stent insertion status, perioperative ureter injury, postoperative infection after URS and related complications, and duration of hospital stay were compared.
While PFS was not detected in 530 patients, PFS was detected in 72 patients. The mean age, male/female ratio, side and localization of the stones, operation time, and perioperative insertion of the double-J after lithotripsy were statistically similar (>0.05). The median stone diameter was smaller in Group 2 (9 mm 8 mm) (=0.033). Fever was observed in 30 and 38 patients in Group 1 and Group 2, respectively (=0.0001). Urinary tract infection was detected in 24 and 27 patients in Group 1 and Group 2, respectively (=0.0001). The urosepsis did not occur in any patients in Group 1, whereas 8 (11.1%) patients in Group 2 experienced urosepsis (=0.0001).
According to the results of the present study, patients with ureteral stones accompanied by PFS are much more prone to ureteral injuries and infectious complications such as urinary tract infection, fever, and sepsis after URS.
肾周脂肪条索影（PFS）是在非增强计算机断层扫描中肾周间隙软组织衰减的线性区域。本研究旨在调查在任何位置患有输尿管结石的患者中，PFS是否与输尿管镜检查（URS）后的感染性并发症相关。
回顾性分析602例接受URS的输尿管结石患者的数据。患者分为两组，第1组（未检测到PFS）和第2组（检测到PFS）。比较患者的性别、年龄、结石大小、侧别和位置、手术时间、双J支架置入情况、围手术期输尿管损伤、URS术后感染及相关并发症，以及住院时间。
530例患者未检测到PFS，72例患者检测到PFS。两组患者的平均年龄、男女比例、结石侧别和位置、手术时间以及碎石术后双J的围手术期置入情况在统计学上相似（>0.05）。第2组的结石中位直径较小（9mm对8mm）（P=0.033）。第1组和第2组分别有30例和38例患者出现发热（P=0.0001）。第1组和第2组分别有24例和27例患者检测到尿路感染（P=0.0001）。第1组患者均未发生尿脓毒症，而第2组有8例（11.1%）患者发生尿脓毒症（P=0.0001）。
根据本研究结果，伴有PFS的输尿管结石患者在URS后更容易发生输尿管损伤和感染性并发症，如尿路感染、发热和脓毒症。
