Ramala Sandeep Reddy, Chandak Suresh R, Avula Hima Swetha, Annareddy Srinivasulareddy
General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Pediatrics, Sri Venkateshwara Medical College, Tirupati, IND.
Cureus. 2024 Sep 13;16(9):e69335. doi: 10.7759/cureus.69335. eCollection 2024 Sep.
Retrograde intrarenal surgery (RIRS) is a minimally invasive procedure increasingly used to treat renal stones and other intrarenal pathologies due to its reduced risk of complications, shorter recovery time, and lower postoperative pain compared to more invasive surgical techniques. However, despite its advantages, RIRS is associated with a significant risk of infectious complications, ranging from simple urinary tract infections (UTIs) to severe systemic infections such as urosepsis, which can lead to increased morbidity, prolonged hospitalization, and, in severe cases, mortality. This review aims to summarize the current knowledge on preventing and managing infectious complications associated with RIRS. By exploring the pathophysiology of these infections, identifying patient and procedural risk factors, and evaluating evidence-based strategies for prevention and management, this review provides comprehensive insights into minimizing infection risks in RIRS. A thorough literature review was conducted, examining studies and clinical trials that address the incidence, risk factors, prevention strategies, and management protocols for infections in RIRS. This review also assesses current guidelines from professional organizations and recent infection control technologies and practices advancements. The review identifies multiple risk factors contributing to infections in RIRS, including patient-specific factors such as comorbidities and procedural factors like the duration of surgery and use of instrumentation. Effective prevention strategies include preoperative antibiotic prophylaxis, stringent aseptic techniques during surgery, and careful postoperative monitoring. The review also highlights the importance of a multidisciplinary approach involving urologists, infectious disease specialists, and microbiologists in managing complex cases of infection. Infectious complications remain a significant concern in RIRS, necessitating a comprehensive approach to prevention and management. By adhering to evidence-based guidelines and utilizing a multidisciplinary strategy, healthcare professionals can significantly reduce the incidence of infections, thereby improving patient outcomes and the overall safety of RIRS. Future research should focus on advancing infection control technologies and developing novel prophylactic and therapeutic approaches to further enhance the safety and effectiveness of RIRS.
逆行性肾内手术（RIRS）是一种微创手术，由于与侵入性更强的手术技术相比，其并发症风险降低、恢复时间更短且术后疼痛较轻，因此越来越多地用于治疗肾结石和其他肾内病变。然而，尽管RIRS具有诸多优势，但它仍与感染性并发症的重大风险相关，范围从简单的尿路感染（UTIs）到严重的全身感染，如尿脓毒症，这可能导致发病率增加、住院时间延长，在严重情况下甚至会导致死亡。本综述旨在总结目前关于预防和管理与RIRS相关的感染性并发症的知识。通过探讨这些感染的病理生理学、识别患者和手术风险因素以及评估基于证据的预防和管理策略，本综述提供了关于将RIRS感染风险降至最低的全面见解。我们进行了全面的文献综述，研究了涉及RIRS感染的发生率、风险因素、预防策略和管理方案的研究及临床试验。本综述还评估了专业组织的现行指南以及近期感染控制技术和实践的进展。该综述确定了导致RIRS感染的多个风险因素，包括患者特定因素，如合并症，以及手术因素，如手术持续时间和器械使用。有效的预防策略包括术前抗生素预防、手术期间严格的无菌技术以及术后仔细监测。该综述还强调了泌尿外科医生、传染病专家和微生物学家多学科方法在处理复杂感染病例中的重要性。感染性并发症仍然是RIRS中的一个重大问题，需要采取全面的预防和管理方法。通过遵循基于证据的指南并采用多学科策略，医疗保健专业人员可以显著降低感染发生率，从而改善患者预后并提高RIRS的整体安全性。未来的研究应专注于推进感染控制技术以及开发新的预防和治疗方法，以进一步提高RIRS的安全性和有效性。
