Effect of Using Automated Irrigation Systems on the Risk of Infectious Complications after Endoscopic Combined Intrarenal Surgery: A Retrospective Cohort Study.
{"title":"Effect of Using Automated Irrigation Systems on the Risk of Infectious Complications after Endoscopic Combined Intrarenal Surgery: A Retrospective Cohort Study.","authors":"Chatporn Boonyapalanant, Rei Unno, Kazumi Taguchi, Sousuke Niwa, Koei Tori, Yasuhito Sue, Takahiro Yanase, Masahiko Isogai, Ryosuke Chaya, Tomoki Okada, Kengo Kawase, Teruaki Sugino, Shuzo Hamamoto, Atsushi Okada, Takahiro Yasui","doi":"10.1089/end.2024.0758","DOIUrl":null,"url":null,"abstract":"<p><p><b><i>Objective:</i></b> Endoscopic combined intrarenal surgery (ECIRS) is a treatment option for kidney stones comparable with other standard methods. One reported complication of ECIRS is infection associated with high intrarenal pressure (IRP), and the irrigation system is an important factor affecting the IRP. Therefore, this study aimed to compare the operative outcomes and infectious complications between manual and gravity irrigation and automated irrigation systems for ECIRS. <b><i>Materials and Methods:</i></b> This single-center, retrospective cohort study enrolled patients who underwent ECIRS between January 2016 and August 2021. We compared operative results and complications between the two irrigation systems, and a multivariate analysis was performed to identify the factors associated with each outcome. <b><i>Results:</i></b> A total of 294 patients were enrolled in this study. The operative time was significantly longer in the manual and gravity irrigation group than in the automated irrigation group (122 ± 45 <i>vs</i> 108 ± 37 minutes, <i>p</i> = 0.003). Postoperative fever occurred in 25% of the patients in the manual and gravity group compared with 10% in the automated group (<i>p</i> < 0.001). In multivariate analysis, the use of a manual and gravity irrigation system was a significant factor associated with postoperative fever (<i>p</i> = 0.001) and longer operative time (<i>p</i> < 0.001). <b><i>Conclusions:</i></b> Using an automated irrigation system for flexible ureteroscopy in ECIRS reduces the risk of postoperative fever and the operative time.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of endourology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1089/end.2024.0758","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Endoscopic combined intrarenal surgery (ECIRS) is a treatment option for kidney stones comparable with other standard methods. One reported complication of ECIRS is infection associated with high intrarenal pressure (IRP), and the irrigation system is an important factor affecting the IRP. Therefore, this study aimed to compare the operative outcomes and infectious complications between manual and gravity irrigation and automated irrigation systems for ECIRS. Materials and Methods: This single-center, retrospective cohort study enrolled patients who underwent ECIRS between January 2016 and August 2021. We compared operative results and complications between the two irrigation systems, and a multivariate analysis was performed to identify the factors associated with each outcome. Results: A total of 294 patients were enrolled in this study. The operative time was significantly longer in the manual and gravity irrigation group than in the automated irrigation group (122 ± 45 vs 108 ± 37 minutes, p = 0.003). Postoperative fever occurred in 25% of the patients in the manual and gravity group compared with 10% in the automated group (p < 0.001). In multivariate analysis, the use of a manual and gravity irrigation system was a significant factor associated with postoperative fever (p = 0.001) and longer operative time (p < 0.001). Conclusions: Using an automated irrigation system for flexible ureteroscopy in ECIRS reduces the risk of postoperative fever and the operative time.
期刊介绍:
Journal of Endourology, JE Case Reports, and Videourology are the leading peer-reviewed journal, case reports publication, and innovative videojournal companion covering all aspects of minimally invasive urology research, applications, and clinical outcomes.
The leading journal of minimally invasive urology for over 30 years, Journal of Endourology is the essential publication for practicing surgeons who want to keep up with the latest surgical technologies in endoscopic, laparoscopic, robotic, and image-guided procedures as they apply to benign and malignant diseases of the genitourinary tract. This flagship journal includes the companion videojournal Videourology™ with every subscription. While Journal of Endourology remains focused on publishing rigorously peer reviewed articles, Videourology accepts original videos containing material that has not been reported elsewhere, except in the form of an abstract or a conference presentation.
Journal of Endourology coverage includes:
The latest laparoscopic, robotic, endoscopic, and image-guided techniques for treating both benign and malignant conditions
Pioneering research articles
Controversial cases in endourology
Techniques in endourology with accompanying videos
Reviews and epochs in endourology
Endourology survey section of endourology relevant manuscripts published in other journals.