The infective complications of the percutaneous nephrolithotomy
DOI: https://dx.doi.org/10.18565/urology.2018.5.128-133
B.G. Guliev, A.Y. Zaikin, O. Ismati
1Department of Urology of FGBOU VO North-Western State Medical University named after I.I. Mechnikov (Head of Department – prof. Komyakov B.K.), Saint Petersburg, Russia; 2Center of Urology with robot-assisted surgery of City Mariinsky hospital (chief – prof. Emelyanov O.V.), Saint Petersburg, Russia
In the article the main causes of the development of infective complications after percutaneous nephrolithotomy and their predictors described by the different authors are presented. A review of studies, dedicated to analysis of baseline risk factors of postoperative fever, systemic inflammatory response syndrome and/or sepsis was conducted. It was established that stone size and true bacteriuria are reliable risk factors as well as technical features of PCNL and the duration of the surgery. The staghorn and multiple stones increase the postoperative complications rate by three times. Despite low incidence of postoperative sepsis after PCNL, it is the serious complication and the main cause of mortality in a postoperative period. The use of prophylactic antibiotics with consideration of bacteria, isolated from the urinary tract significantly reduces the incidence of the postoperative infectious complications. The scheme of a single injection of the antibiotic 30 minutes before the surgery is effective.
Keywords: urinary stone disease, percutaneous treatment, nephrolithotomy, complications, urinary tract infections, sepsis
About the Autors
Corresponding author: B.G. Guliev – Dr.Med.Sci., professor at the department of urology of FGBOU VO North-Western State Medical University named after I.I. Mechnikov, Head of Center of Urology with robot-assisted surgery of City Mariinsky hospital, Saint Petersburg, Russia; e-mail: gulievbg@mail.ru