{"title":"使用自动冲洗系统对内镜联合肾内手术后感染并发症风险的影响:一项回顾性队列研究。","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":"{\"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}","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
摘要
目的:内镜联合肾内手术(ECIRS)是肾结石治疗的一种可与其他标准方法相媲美的选择。据报道,ECIRS的一个并发症是感染与高肾内压(IRP)相关,而灌洗系统是影响IRP的重要因素。因此,本研究旨在比较人工、重力灌洗和自动灌洗系统对ECIRS的手术效果和感染并发症。材料和方法:这项单中心、回顾性队列研究纳入了2016年1月至2021年8月期间接受ECIRS治疗的患者。我们比较了两种灌洗系统的手术结果和并发症,并进行了多变量分析以确定与每种结果相关的因素。结果:本研究共纳入294例患者。手动冲洗组和重力冲洗组的手术时间明显长于自动冲洗组(122±45 vs 108±37 min, p = 0.003)。手动和重力组术后发热发生率为25%,而自动组为10% (p < 0.001)。在多变量分析中,人工和重力冲洗系统的使用是术后发热(p = 0.001)和手术时间延长(p < 0.001)的重要因素。结论:在ECIRS软输尿管镜手术中使用自动冲洗系统可减少术后发热的风险和手术时间。
Effect of Using Automated Irrigation Systems on the Risk of Infectious Complications after Endoscopic Combined Intrarenal Surgery: A Retrospective Cohort Study.
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.