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CC BY-NC-ND 4.0 · Revista Urología Colombiana / Colombian Urology Journal 2021; 30(02): 105-111
DOI: 10.1055/s-0040-1721322
Original Article | Artículo Original

Factores asociados a complicaciones infecciosas posoperatorias en pacientes con urolitiasis

Factors Associated with Postoperative Infectious Complications in Patients with Urolitiasis
Javier Osorio-Manrique
1   Centro Especializado de Urología. Neiva, Colombia
,
Jorge Andres Ramos-Castaneda 
2   Universidad CES, Medellín, Colombia
,
Elsa Garcia-Landazabal
1   Centro Especializado de Urología. Neiva, Colombia
,
Maria Paula Molano-Garcia
3   Universidad Pedagógica y Tecnológica de Colombia, Tunja, Colombia
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Resumen

Introducción Se encuentran múltiples tratamientos para la urolitiasis, los cuales dependen en gran medida del tamaño y la ubicación de la litiasis. Dentro de las opciones terapéuticas se encuentran la expulsión activa, utilización de ondas de choque, las ureterolitotomias, y procedimientos endoscópicos, todas con diferentes tasas de efectividad y riesgo de complicación infecciosa. El objetivo del estudio fue evaluar los factores asociados a la complicación infecciosa posterior al procedimiento urológico en pacientes con urolitiasis.

Métodos Estudio de casos y controles anidado a una cohorte de pacientes programados para procedimientos urológicos como tratamiento para la urolitiasis durante el periodo 2015 - 2019. Se consideraron casos, aquellos con complicación infecciosa posoperatoria dentro de los 30 días posteriores al procedimiento urológico. Los controles se seleccionaron de la cohorte inicial y fueron los pacientes que no presentaron complicación infecciosa.

Resultados En el periodo de estudio, fueron atendidos 350 pacientes con litiasis renal, con un total de 1258 cálculos. El número promedio de cálculos por paciente fue de 3,59; la prevalencia de litiasis bilateral fue del 57%, siendo similar la cantidad de cálculos en el lado izquierdo (promedio = 1,4) y en el derecho (promedio = 1,44).

La tasa de complicación infecciosa posquirúrgica fue del 4% (n= 14) y se asoció con la presencia de al menos un cálculo mayor de 20 mm (OR 4,49 IC95% 1,39–14,52).

Conclusión La tasa de complicación infecciosa posoperatoria en pacientes con urolitiasis y programados para procedimientos urológicos es baja. Una longitud del cálculo mayor de 20 mm es un factor asociado a la infección posoperatoria.

Abstract

Introduction There are multiple treatments for urolithiasis, which largely depend on the size and location of the lithiasis. Among the therapeutic options are active expulsion, use of shock waves, urolithotomies, and endoscopic procedures, all with different rates of effectiveness and risk of infectious complications. The objective of the study was to evaluate the factors associated with the infectious complication after the urological procedure in patients with urolithiasis.

Methods Case-control study nested in a cohort of patients scheduled for urological procedures as treatment for urolithiasis during the period 2015-2019. Cases were considered, those with postoperative infectious complication within 30 days after the urological procedure. The controls were selected from the initial cohort and were the patients who did not present an infectious complication.

Results During the study period, 350 patients with kidney stones were treated, with a total of 1258 stones. The average number of stones per patient was 3.59; the prevalence of bilateral lithiasis was 57%, the number of stones being similar on the left side (average = 1.4) and on the right (average = 1.44). The postoperative infectious complication rate was 4% (n = 14) and was associated with the presence of at least one stone larger than 20 mm (OR 4.49 95% CI 1.39 - 14.52).

Conclusion The postoperative infectious complication rate in patients with urolithiasis and scheduled for urological procedures is low. A stone length greater than 20 mm is a factor associated with postoperative infection.

Palabras clave

urolitisiasis - infección - procedimiento urológico

Keywords

urolitisiasis - infection - urological procedure


Publication History

Received: 09 June 2020

Accepted: 25 August 2020

Article published online:
04 February 2021

© 2021. Sociedad Colombiana de Urología. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • Referencias

  • 1 Gottlieb M, Long B, Koyfman A. The evaluation and management of urolithiasis in the ED: A review of the literature. Am J Emerg Med 2018; 36 (04) 699-706
    CrossrefPubMedGoogle Scholar
  • 2 Ingimarsson JP, Krambeck AE, Pais Jr VM. Diagnosis and Management of Nephrolithiasis. Surg Clin North Am 2016; 96 (03) 517-532
    CrossrefPubMedGoogle Scholar
  • 3 Moe OW. Kidney stones: pathophysiology and medical management. Lancet 2006; 367 (9507): 333-344
    CrossrefPubMedGoogle Scholar
  • 4 Portis AJ, Sundaram CP. Diagnosis and initial management of kidney stones. Am Fam Physician 2001; 63 (07) 1329-1338
    PubMedGoogle Scholar
  • 5 Jiao B, Lai S, Xu X, Zhang M, Diao T, Zhang G. The efficacy of flexible ureteroscopy lithotripsy and miniaturized percutaneous nephrolithotomy for the treatment of renal and proximal ureteral calculi of ≤2 cm: A retrospective study. Medicine (Baltimore) 2019; 98 (11) e14535
    CrossrefPubMedGoogle Scholar
  • 6 Sorokin I, Mamoulakis C, Miyazawa K, Rodgers A, Talati J, Lotan Y. Epidemiology of stone disease across the world. World J Urol 2017; 35 (09) 1301-1320
    CrossrefPubMedGoogle Scholar
  • 7 Adela-Emilia GAyala. Litiasis Renal. Etiopatogenia, clínica y factores de riesgo. Rev Clínica Med Fam 2008; 2: 32-38
    PubMedGoogle Scholar
  • 8 Kravdal G, Helgø D, Moe MK. Kidney stone compositions and frequencies in a Norwegian population. Scand J Urol 2019; 53 (2-3): 139-144
    CrossrefPubMedGoogle Scholar
  • 9 Taylor EN, Stampfer MJ, Curhan GC. Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up. J Am Soc Nephrol 2004; 15 (12) 3225-3232
    CrossrefPubMedGoogle Scholar
  • 10 Fernández Alcalde ÁA, Ruiz Hernández M, Gómez Dos Santos V. et al. Comparación entre nefrolitotomía percutánea y ureteroscopia flexible para el tratamiento de litiasis renales de entre 2 y 3cm. Actas Urol Esp 2019; 43 (03) 111-117
    CrossrefPubMedGoogle Scholar
  • 11 Türk C, Knoll T, Petrik A, Sarica K, Straub M, Seitz C. Guidelines on urolithiasis. Eur Assoc Urol 2017
    PubMedGoogle Scholar
  • 12 Pan J, Chen Q, Xue W. et al. RIRS versus mPCNL for single renal stone of 2-3 cm: clinical outcome and cost-effective analysis in Chinese medical setting. Urolithiasis 2013; 41 (01) 73-78
    CrossrefPubMedGoogle Scholar
  • 13 Zengin K, Tanik S, Karakoyunlu N. et al. Retrograde intrarenal surgery versus percutaneous lithotripsy to treat renal stones 2-3 cm in diameter. BioMed Res Int 2015; 2015: 914231
    CrossrefPubMedGoogle Scholar
  • 14 Pieras E, Tubau V, Brugarolas X, Ferrutxe J, Pizá P. Comparative analysis between percutaneous nephrolithotomy and flexible ureteroscopy in kidney stones of 2–3 cm. Actas Urol Esp Engl Ed 2017; 41: 194-199
    PubMedGoogle Scholar
  • 15 Ramos-Castaneda JA, Ruano-Ravina A, Munoz-Price LS. et al. Risk of infection in patients undergoing urologic surgery based on the presence of asymptomatic bacteriuria: A prospective study. Am J Infect Control 2019; 47 (12) 1474-1478
    CrossrefPubMedGoogle Scholar
  • 16 Team Rs. RStudio: integrated development for R. RStudio Inc; Boston MA: URL Httpwww Rstudio Com 2015: 42
    Google Scholar
  • 17 Stamatelou KK, Francis ME, Jones CA, Nyberg Jr LM, Curhan GC. Time trends in reported prevalence of kidney stones in the United States: 1976-1994. Kidney Int 2003; 63 (05) 1817-1823
    CrossrefPubMedGoogle Scholar
  • 18 Hesse A, Brändle E, Wilbert D, Köhrmann K-U, Alken P. Study on the prevalence and incidence of urolithiasis in Germany comparing the years 1979 vs. 2000. Eur Urol 2003; 44 (06) 709-713
    CrossrefPubMedGoogle Scholar
  • 19 Tasian GE, Jemielita T, Goldfarb DS. et al. Oral Antibiotic Exposure and Kidney Stone Disease. J Am Soc Nephrol 2018; 29 (06) 1731-1740
    CrossrefPubMedGoogle Scholar
  • 20 Pieras E, Ruiz J, Vicens A, Frontera G, Grases F, Pizá P. Multivariate analysis of predictive factors in the evolution of renal lithiasis. Actas Urol Esp Engl Ed 2012; 36: 346-351
    CrossrefPubMedGoogle Scholar
  • 21 Bai T, Yu X, Qin C. et al. Identification of Factors Associated with Postoperative Urosepsis after Ureteroscopy with Holmium: Yttrium-Aluminum-Garnet Laser Lithotripsy. Urol Int 2019; 103 (03) 311-317
    CrossrefPubMedGoogle Scholar
  • 22 Ramos-Castaneda JA, Ruano-Ravina A, Salinas DF, Osorio-Manrique J, Segura-Cardona AM, Lemos-Luengas EV. Factors associated with multidrug-resistant bacteria in a cohort of patients with asymptomatic bacteriuria who underwent urological surgery. Am J Infect Control 2019; 47 (12) 1479-1483
    CrossrefPubMedGoogle Scholar
  • 23 Ziemba JB, Matlaga BR. Epidemiology and economics of nephrolithiasis. Investig Clin Urol 2017; 58 (05) 299-306
    CrossrefPubMedGoogle Scholar
  • 24 Ramos JA, Salinas DF, Osorio J, Ruano-Ravina A. Antibiotic prophylaxis and its appropriate timing for urological surgical procedures in patients with asymptomatic bacteriuria: A systematic review. Arab J Urol 2016; 14 (03) 234-239
    CrossrefPubMedGoogle Scholar
  • 25 Rivera ME, Bhojani N, Heinsimer K. et al. A survey regarding preference in the management of bilateral stone disease and a comparison of Clavien complication rates in bilateral vs unilateral percutaneous nephrolithotomy. Urology 2018; 111: 48-53
    CrossrefPubMedGoogle Scholar