Abstract
Purpose
Retrograde intrarenal surgery (RIRS) is considered a safe procedure; however, infective complications are potentially serious postoperative complications. The aim of this multicentre study was to evaluate prospectively the prevalence of infective complications after RIRS and identify risk factors.
Methods
Baseline data were collected, and patients were questioned regarding postoperative infective complications following RIRS. The Fisher exact test, Student t test, Mann–Whitney U test, and multivariate regression analysis were used for data analysis.
Results
A total of 403 patients from five European centers were included. Antibiotic prophylaxis was administered prior to RIRS in 100 %. Infection complications were recorded in 31 patients (7.7 %), consisting of fever in 18 (4.4 %), SIRS in 7 (1.7), and sepsis in 3 (0.7 %). Three required hospitalization for non-obstructive pyelonephritis (0.7 %). Univariate analysis revealed that coronary heart disease, chronic kidney disease, alteration of lipid metabolism, anticoagulant therapy, past surgery for renal stone, presence of residual fragments were predictors of infective complications. Multivariate analysis did not identify any patient subgroups at a significantly higher risk of infection. The low rate of complications may have limited the conclusions from our study.
Conclusion
Using a standardized method for the definition and classification of infective complication from a multicentre prospective large database, we find a prevalence of 7.7 % of infective complication among patients undergoing RIRS for renal stone. However, to predict which patients will develop infective complications still remains a clinical challenge.
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Guido Giusti is a consultant for Boston Scientific, Cook Medical, Porges-Coloplast, Karl Storz. Cesare Mario Scoffone is a consultant for Boston Scientific, Cook Medical, Porges-Coloplast, Karl Storz. F. Berardinelli, L. Cindolo, P. De Francesco, N. Cera, M. Marchioni, S. Proietti, D. Hennessey, O. Dalpiaz, C. Cracco, and L. Schips have nothing to disclose.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
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Informed consent was obtained from all individual participants included in the study.
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Berardinelli, F., De Francesco, P., Marchioni, M. et al. Infective complications after retrograde intrarenal surgery: a new standardized classification system. Int Urol Nephrol 48, 1757–1762 (2016). https://doi.org/10.1007/s11255-016-1373-1
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DOI: https://doi.org/10.1007/s11255-016-1373-1