Abstract

Objective To investigate the risk factors of systemic inflammatory response syndrome (SIRS) induced by flexible ureteroscope combined with Holmium laser lithotripsy. Patients and Methods. The clinical data from 216 consecutive patients who had undergone flexible ureteroscope combined with Holmium laser lithotripsy between August 2015 and May 2019 were retrospectively analyzed. To identify the risk factors of systemic inflammatory response syndrome induced by flexible ureteroscope combined with Holmium laser lithotripsy, the cases were divided into two groups according to whether they developed postoperative SIRS: SIRS group (21 cases) and non-SIRS group (195 cases). Age, gender, body mass index, stone size, surgery time, stone location, hydronephrosis, urine culture, hospital stay, stone-free rate, ureteral access sheath, and diabetes mellitus were collected. Univariate analysis was performed to calculate the potential factors. In order to determine the independence of the various factors, factors that potentially contributed to SIRS were compared between the SIRS group and the non-SIRS group. Furthermore, multivariate logistic regression analysis was used to identify the risk factors of systemic inflammatory response syndrome induced by flexible ureteroscopic lithotripsy. Results All patients were successfully treated with flexible ureteroscopic lithotripsy. The incidence of SIRS after flexible ureteroscopic lithotripsy was 9.7%. The univariate analysis demonstrated the potential risk factors of systemic inflammatory response syndrome induced by flexible ureteroscopic lithotripsy were stone size (p = 0.002), surgery time (p = 0.002), surgery time (p = 0.002), surgery time (p = 0.002), surgery time (p = 0.002), surgery time (p = 0.002), surgery time (p = 0.002), surgery time (p = 0.002), surgery time (Conclusions Stone size, surgery time, urine culture, and ureteral access sheath are independent risk factors for SIRS induced by flexible ureteroscopic lithotripsy. Patients with these high-risk factors should be carefully evaluated to reduce systemic inflammatory response syndrome.

Highlights

  • Flexible ureteroscopic lithotripsy has become an effective and valued procedure in the treatment of upper urinary tract stones

  • Multivariate logistic regression analysis was used to identify the independent risk factors for Systemic inflammatory response syndrome (SIRS) induced by flexible ureteroscopic lithotripsy

  • In multivariate logistic regression analysis, stone size (p = 0:002, Odds ratio CI (OR) = 1:618; 95% CI, 0.452-0.844), surgery time (p ≤ 0:001, OR = 1:025; 95% CI, 1.016-1.034), urine culture (p ≤ 0:001, OR = 25:795; 95% CI, 22.131-30.065), and ureteral access sheath (p ≤ 0:001, OR = 6:101; 95% CI, 5.109-7.284) were identified as independent risk factors for SIRS induced by flexible ureteroscopic lithotripsy

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Summary

Introduction

Flexible ureteroscopic lithotripsy has become an effective and valued procedure in the treatment of upper urinary tract stones. Flexible ureteroscopic lithotripsy is a minimally invasive technique, it carries the potential risk of complications. Systemic inflammatory response syndrome (SIRS) is a common and serious complication associated with flexible ureteroscopic lithotripsy. Senocak et al reported that the incidence of postoperative infectious complications after flexible ureteroscopic lithotripsy was 8.5% [1]. SIRS prolongs hospitalization time and affects the prognosis of patients [2]. SIRS might further develop into multiple organ dysfunction. It is important to identify the risk factors of systemic inflammatory response syndrome induced by flexible ureteroscope lithotripsy

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