軟式輸尿管鏡取石手術後發燒之分析—單一醫學中心經驗
李宗叡、謝博帆、連啟舜
中國醫藥大學附設醫院 泌尿部
Incidence and analysis of fever episode after retrograde intrarenal surgery—CMUH experience
Tzung-Ruei Li, Po-Fan Hsieh, Chi-Shuen Lien
Department of Urology, China Medical University Hospital, Taichung, Taiwan
Purpose:
Retrograde intrarenal surgery(RIRS) had gained its popularity in the management of renal and ureteral stones. However, post-operative sepsis was one of the possible complications. We aimed to analyze the incidence of fever after RIRS in a single center.
Materials and Methods:
This retrospective study recruited 234 patients who received RIRS from Aug. 2018 to Aug 2019 by two experienced surgeons. All the patients had antibiotics use before the surgery. We tried to identify the predictors of the post-operation fever or sepsis. All the statistical analysis was performed with SPSS 25.0.
Results:
Among the patients, the mean age was 60.25±14.75. 126 patients (53.8%) were male. 43 patients (18.5%) received bilateral side of RIRS. The average surgery duration was 102.55±43.35 minutes. After the surgery, 26 (11.1%) patients suffered from fever or sepsis after RIRS. There was significant difference in age (69.46±14.82; 59.01±14.37, p=0.001), bilateral stone treatments (34.6%; 17.3%, p=0.035) between febrile or sepsis and afebrile groups. There was no difference in pre-operative WBC counts, renal function, diabetic mellitus, stone location, stone burden or surgery duration. There was not predominant species of the bacteria yielded from the culture in febrile group.
Conclusions:
The incidence of post-operation fever after RIRS in our center was 11.1%. Older age and bilateral renal stone treatment are the two factors for occurrence of fever, and therefore we could be more cautious in manipulation or adjust the antibiotics from previous culture in these certain patients.