ENDOSKOPİK TAŞ CERRAHİSİNDE KULLANILAN İRRİGASYON SIVISININ ENFEKTİF SÜREÇLERE ETKİSİ
Öz
Amaç: Endoskopik üriner sistem taşı tedavisinde kullanılan irrigasyon sıvısı miktarının enfektif süreçlere etkisini araştırmak
Gereç ve Yöntemler: Çalışmaya, Ocak 2018 ile Ocak 2020 tarihleri arasında hastanemiz üroloji kliniğine üriner sistem taşı nedeniyle başvurmuş ve bu nedenle endoskopik litotripsi uygulanmış 77 hastanın verileri dahil edildi. İşlem sonrasında enfeksiyon gelişmeyen hastalar Grup 1, postoperatif enfeksiyon gelişen hastalar ise Grup 2 olarak kategorize edildi. Sonrasında bu iki grup arasında kullanılan irrigasyon sıvısı miktarı açısından fark olup olmadığı araştırıldı.
Bulgular: Grup 1’de 45 hasta, Grup 2’de 32 hasta mevcuttu. İrrigasyon amaçlı kullanılan %0,9 NaCl sıvısı miktarı ortalama olarak 2142±1126,01 ml’dir. Kullanılan irrigasyon sıvısı miktarı postoperatif enfeksiyon gelişen grup için ortalama 2309,38±1220,4 ml, postoperatif enfeksiyon gözlenmeyen grup içinse ortalama 2023,3±1051,6 ml’dir ve her iki grup kullanılan irrigasyon sıvısının miktarı açısından karşılaştırıldığında anlamlı bir farklılık saptanmamıştır (p=0,275).
Sonuç: Kullanılan irrigasyon sıvı miktarının bu süreçte önemli bir faktör olduğunu düşünsek de çalışmamız sonucunda anlamlı bir fark saptayamadık. Bu durum enfeksiyöz süreçlerde bir faktörün tek basına yol açmadığını diğer birçok etmenin bir araya gelip kümülatif bir etki yarattığı yönündedir.
Anahtar Kelimeler
Destekleyen Kurum
yok
Proje Numarası
yok
Teşekkür
yok
Kaynakça
- 1. Williams JG, Turney BW, Rauniyar NP, Harrah TP, Waters SL, Moulton DE. The Fluid Mechanics of Ureteroscope Irrigation. J Endourol. 2019;33(1):28-34.
- 2. Jung H, Osther PJ. Intraluminal pressure profiles during flexible ureterorenoscopy. Springerplus. 2015;4:373.
- 3. Trinchieri A. Epidemiology of urolithiasis: an update. Clin Cases Miner Bone Metab. 2008;5(2):101-6.
- 4. Muslumanoglu AY, Binbay M, Yuruk E, Akman T, Tepeler A, Esen T, et al. Updated epidemiologic study of urolithiasis in Turkey. I: Changing characteristics of urolithiasis. Urol Res. 2011;39(4):309-14.
- 5. Aboumarzouk OM, Monga M, Kata SG, Traxer O, Somani BK. Flexible ureteroscopy and laser lithotripsy for stones >2 cm: a systematic review and meta-analysis. J Endourol. 2012;26(10):1257-63.
- 6. Hyams ES, Monga M, Pearle MS, Antonelli JA, Semins MJ, Assimos DG, et al. A prospective, multi-institutional study of flexible ureteroscopy for proximal ureteral stones smaller than 2 cm. J Urol. 2015;193(1):165-9.
- 7. Komeya M, Odaka H, Asano J, Asai T, Saigusa Y, Ogawa T, et al. Development and internal validation of a nomogram to predict perioperative complications after flexible ureteroscopy for renal stones in overnight ureteral catheterization cases. World J Urol. 2019.
- 8. Baboudjian M, Gondran-Tellier B, Abdallah R, Sichez PC, Akiki A, Gaillet S, et al. Predictive risk factors of urinary tract infection following flexible ureteroscopy despite preoperative precautions to avoid infectious complications. World J Urol. 2019.
- 9. Breda A, Angerri O. Retrograde intrarenal surgery for kidney stones larger than 2.5 cm. Curr Opin Urol. 2014;24(2):179-83.
- 10. Xu Y, Min Z, Wan SP, Nie H, Duan G. Complications of retrograde intrarenal surgery classified by the modified Clavien grading system. Urolithiasis. 2018;46(2):197-202.
- 11. Suh LK, Rothberg MB, Landman J, Katsumi H, Gupta M. Intrarenal pressures generated during deployment of various antiretropulsion devices in an ex vivo porcine model. J Endourol. 2010;24(7):1165-8.
- 12. Thomsen HS. Pyelorenal backflow. Clinical and experimental investigations. Radiologic, nuclear, medical and pathoanatomic studies. Dan Med Bull. 1984;31(6):438-57.
- 13. Osther PJS. Risks of flexible ureterorenoscopy: pathophysiology and prevention. Urolithiasis. 2018;46(1):59-67.
- 14. Zhong W, Leto G, Wang L, Zeng G. Systemic inflammatory response syndrome after flexible ureteroscopic lithotripsy: a study of risk factors. J Endourol. 2015;29(1):25-8.
- 15. McAleer IM, Kaplan GW, Bradley JS, Carroll SF, Griffith DP. Endotoxin content in renal calculi. J Urol. 2003;169(5):1813-4.
- 16. Ofstead CL, Heymann OL, Quick MR, Johnson EA, Eiland JE, Wetzler HP. The effectiveness of sterilization for flexible ureteroscopes: A real-world study. Am J Infect Control. 2017;45(8):888-95.
The Effect of Irrigation Fluid Used in Endoscopic Stone Surgery on Infective Processes
Öz
Aim: To investigate the effect of irrigation fluid amount used in the treatment of endoscopic urinary tract stones on infective processes
Materials and Methods: The data of 77 patients who applied to the urology clinic of our hospital between January 2018 and January 2020 due to urinary tract stones and therefore performed endoscopic lithotripsy were included in the study. Patients who did not develop infection after the procedure were categorized as Group 1 and patients who developed postoperative infection were classified as Group 2. Afterwards, it was investigated whether there is a difference in the amount of irrigation fluid used between these two groups.
Results: Group 1 had 45 patients and Group 2 had 32. The amount of 0.9% NaCl fluid used for irrigation is 2142 ± 1126.01 ml on average. The average amount of irrigation fluid used was 2309.38 ± 1220.4 ml for the group developing postoperative infection, and 2023.3 ± 1051.6 ml for the group without postoperative infection, and no significant difference was found in terms of the amount of irrigation fluid used in both groups ( p = 0.275).
Conclusion: Although we thought that the amount of irrigation fluid used was an important factor in this process, we could not detect a significant difference as a result of our study. This situation is that one factor does not cause alone in infectious processes and many other factors come together and create a cumulative effect.
Anahtar Kelimeler
Proje Numarası
yok
Kaynakça
- 1. Williams JG, Turney BW, Rauniyar NP, Harrah TP, Waters SL, Moulton DE. The Fluid Mechanics of Ureteroscope Irrigation. J Endourol. 2019;33(1):28-34.
- 2. Jung H, Osther PJ. Intraluminal pressure profiles during flexible ureterorenoscopy. Springerplus. 2015;4:373.
- 3. Trinchieri A. Epidemiology of urolithiasis: an update. Clin Cases Miner Bone Metab. 2008;5(2):101-6.
- 4. Muslumanoglu AY, Binbay M, Yuruk E, Akman T, Tepeler A, Esen T, et al. Updated epidemiologic study of urolithiasis in Turkey. I: Changing characteristics of urolithiasis. Urol Res. 2011;39(4):309-14.
- 5. Aboumarzouk OM, Monga M, Kata SG, Traxer O, Somani BK. Flexible ureteroscopy and laser lithotripsy for stones >2 cm: a systematic review and meta-analysis. J Endourol. 2012;26(10):1257-63.
- 6. Hyams ES, Monga M, Pearle MS, Antonelli JA, Semins MJ, Assimos DG, et al. A prospective, multi-institutional study of flexible ureteroscopy for proximal ureteral stones smaller than 2 cm. J Urol. 2015;193(1):165-9.
- 7. Komeya M, Odaka H, Asano J, Asai T, Saigusa Y, Ogawa T, et al. Development and internal validation of a nomogram to predict perioperative complications after flexible ureteroscopy for renal stones in overnight ureteral catheterization cases. World J Urol. 2019.
- 8. Baboudjian M, Gondran-Tellier B, Abdallah R, Sichez PC, Akiki A, Gaillet S, et al. Predictive risk factors of urinary tract infection following flexible ureteroscopy despite preoperative precautions to avoid infectious complications. World J Urol. 2019.
- 9. Breda A, Angerri O. Retrograde intrarenal surgery for kidney stones larger than 2.5 cm. Curr Opin Urol. 2014;24(2):179-83.
- 10. Xu Y, Min Z, Wan SP, Nie H, Duan G. Complications of retrograde intrarenal surgery classified by the modified Clavien grading system. Urolithiasis. 2018;46(2):197-202.
- 11. Suh LK, Rothberg MB, Landman J, Katsumi H, Gupta M. Intrarenal pressures generated during deployment of various antiretropulsion devices in an ex vivo porcine model. J Endourol. 2010;24(7):1165-8.
- 12. Thomsen HS. Pyelorenal backflow. Clinical and experimental investigations. Radiologic, nuclear, medical and pathoanatomic studies. Dan Med Bull. 1984;31(6):438-57.
- 13. Osther PJS. Risks of flexible ureterorenoscopy: pathophysiology and prevention. Urolithiasis. 2018;46(1):59-67.
- 14. Zhong W, Leto G, Wang L, Zeng G. Systemic inflammatory response syndrome after flexible ureteroscopic lithotripsy: a study of risk factors. J Endourol. 2015;29(1):25-8.
- 15. McAleer IM, Kaplan GW, Bradley JS, Carroll SF, Griffith DP. Endotoxin content in renal calculi. J Urol. 2003;169(5):1813-4.
- 16. Ofstead CL, Heymann OL, Quick MR, Johnson EA, Eiland JE, Wetzler HP. The effectiveness of sterilization for flexible ureteroscopes: A real-world study. Am J Infect Control. 2017;45(8):888-95.