Photo Credit: Shivendu Jauhari

The following is a summary of “Risk factors of systemic inflammatory response syndrome after minimally invasive percutaneous nephrolithotomy with a controlled irrigation pressure,” published in the December 2024 issue of Urology by Lan et al. 

Researchers conducted a retrospective study to identify risk factors for systemic inflammatory response syndrome (SIRS) after minimally invasive percutaneous nephrolithotomy (PCNL) with controlled irrigation pressure. 

They retrospectively reviewed 303 consecutive patients who underwent first-stage PCNL between July 2016 and June 2018. The procedures were performed with an 18 F tract, using an irrigation pump set at 110 mmHg pressure and a 0.4 L/min flow rate. SIRS and sepsis were recorded postoperatively, and demographic data, clinical features, and test results were analyzed. 

The results showed that 52 patients (17.2%) developed SIRS, and 3 patients (0.99%) progressed to severe sepsis. Univariate analysis identified stone size, operative time, history of diabetes mellitus (DM), glycosylated hemoglobin, history of ipsilateral surgery, preoperative urine culture, staghorn calculi, pelvic urine culture, stone culture, number of tracts, blood transfusion, and residual stones as significantly correlated with post-PCNL SIRS (P < 0.05). Multivariate analysis identified stone size (OR = 3.743, P = 0.012), preoperative urine culture (OR = 2.526, P = 0.042), pelvic urine culture (OR = 13.523, P < 0.001), number of tracts (OR = 8.945, P = 0.002), and blood transfusion (OR = 26.308, P < 0.001) as independent risk factors for post-PCNL SIRS. 

Investigators found that stone size (>4cm²), positive urine cultures, multiple tracts, and blood transfusion were independent risk factors for SIRS under pressure-controlled conditions. Increased attention was advised for patients with these factors. 

Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-024-01680-9