Department of Urology, University of Health Sciences, Erzurum City Hospital, Erzurum, Turkey.
Department of Urology, Liv Hospital Vadiistanbul, Istanbul, Turkey.
J Laparoendosc Adv Surg Tech A. 2024 Nov;34(11):1007-1013. doi: 10.1089/lap.2024.0267. Epub 2024 Aug 21.
In order to prevent infectious complications following endourological procedure of upper urinary tract stones, it is essential to determine which patients are at high risk of developing this complication. We aimed to identify predictors that may cause systemic inflammatory response syndrome (SIRS) after the endourological procedure of upper urinary tract stones. Patients who underwent percutaneous nephrolithotomy (PNL), flexible ureteroscopy (F-URS), or semirigid ureteroscopy (SR-URS) in our center between January 2011 and June 2020 were evaluated retrospectively. After surgery, patients were pursued for SIRS criteria. Logistic regression analyses were applied to identify predictors of SIRS. A total of 1471 patients were included in the study. The rates of SIRS after PNL, F-URS, and SR-URS were 12.9%, 6.3%, and 1.7%, respectively. In multivariate analysis, predictors for SIRS were determined to be stone volume, operative time, and history of recurrent urinary tract infection (UTI) in the PNL group; ipsilateral stone surgery history, stone volume, and operative time in the F-URS group; and stone volume, operative time, and history of recurrent UTI in the SR-URS group. Stone volume and operative time were determined to be independent predictors of SIRS in endourological surgery of upper urinary tract stones.
为了预防上尿路结石内镜术后感染性并发症，确定哪些患者有发生该并发症的高风险至关重要。我们旨在确定可能导致上尿路结石内镜术后全身炎症反应综合征（SIRS）的预测因素。
回顾性分析了 2011 年 1 月至 2020 年 6 月期间在我中心接受经皮肾镜碎石术（PNL）、软性输尿管镜（F-URS）或半硬性输尿管镜（SR-URS）治疗的患者。术后对患者进行 SIRS 标准检测。采用逻辑回归分析确定 SIRS 的预测因素。
共有 1471 例患者纳入研究。PNL、F-URS 和 SR-URS 后 SIRS 的发生率分别为 12.9%、6.3%和 1.7%。多因素分析确定 PNL 组中 SIRS 的预测因素为结石体积、手术时间和复发性尿路感染（UTI）史；F-URS 组为同侧结石手术史、结石体积和手术时间；SR-URS 组为结石体积、手术时间和复发性 UTI 史。
结石体积和手术时间是上尿路结石内镜手术中 SIRS 的独立预测因素。
