Department of Urology, Ankara City Hospital, Ankara, Turkey.
Department of Urology, Ankara Training and Research Hospital, Ankara, Turkey.
World J Urol. 2024 Apr 10;42(1):229. doi: 10.1007/s00345-024-04903-8.
To present a new protocol using antibiotic irrigation during lithotripsy in retrograde intrarenal surgery (RIRS) to provide sterility of the renal collecting system.
This prospective study included 102 patients who underwent RIRS between January 2022 and August 2023. The patients were examined in two groups as those who received antibiotic irrigation (n:51) and standard irrigation (n:51). In the antibiotic irrigation group, 80 mg of gentamicin was dissolved in normal saline in a 3 L irrigation pouch to obtain a 26.7 mg/L concentration. In the standard irrigation group, normal saline was used. Preoperative information, including age, sex, body mass index (BMI), ASA score, stone side, volume, and density, and the Seoul National University Renal Stone Complexity (S-ReSC) score. The groups were compared with respect to postoperative fever (> 38 °C), urinary tract infection (UTI), systemic inflammatory response syndrome (SIRS), infectious complications such as sepsis, and stone-free rate.
No statistically significant difference was determined between the groups with respect to age, sex, BMI, ASA score, stone side, volume and density, and S-ReSC score (p > 0.05 for all). Statistically significant differences were determined between the groups with respect to postoperative fever (p = 0.05), SIRS (p = 0.05), and hospital length of stay (p = 0.05). Sepsis was observed in one patient in the standard irrigation group and in none of the antibiotic irrigation group.
The reliability, efficacy, and utility of antibiotic irrigation during lithotripsy in RIRS were presented in this study as a new protocol for sterilization of the renal collecting system which will be able to reduce infectious complications.
提出一种新的方案，即在逆行性肾内手术（RIRS）的碎石术中使用抗生素冲洗，以提供肾集合系统的无菌性。
本前瞻性研究纳入了 2022 年 1 月至 2023 年 8 月期间接受 RIRS 的 102 例患者。患者分为接受抗生素冲洗组（n=51）和标准冲洗组（n=51）。在抗生素冲洗组中，将 80mg 庆大霉素溶解在 3L 冲洗袋中的生理盐水，以获得 26.7mg/L 的浓度。在标准冲洗组中，使用生理盐水。比较两组患者的术后发热（>38°C）、尿路感染（UTI）、全身炎症反应综合征（SIRS）、感染性并发症（如败血症）、结石清除率等术前信息，包括年龄、性别、体重指数（BMI）、ASA 评分、结石侧、体积和密度以及首尔国立大学肾结石复杂性评分（S-ReSC）。
两组患者的年龄、性别、BMI、ASA 评分、结石侧、体积和密度以及 S-ReSC 评分均无统计学差异（p>0.05）。两组术后发热（p=0.05）、SIRS（p=0.05）和住院时间（p=0.05）有统计学差异。标准冲洗组有 1 例患者发生败血症，抗生素冲洗组无败血症。
本研究提出了一种新的方案，即在 RIRS 的碎石术中使用抗生素冲洗，作为一种为肾集合系统消毒的新方案，以降低感染性并发症的发生率。
