UrologiiaUrologiiaУрология1728-29852414-9020Bionika Media29640610.18565/urology.2018.5.128-133ArticlesСтатьиResearch ArticleThe infective complications of the percutaneous nephrolithotomyИнфекционные осложнения перкутанной нефролитотрипсииGulievB. GГулиевБ. Г

Dr.Med.Sci., professor at the department of urology

д.м.н., профессор кафедры урологии СЗГМУ им. Мечникова, руководитель центра урологии с робот-ассистированной хирургией Мариинской больницы

gulievbg@mail.ruZaikinA. YЗаикинА. Ю

resident of distant learning at the department of urology

заочный ординатор кафедры урологии

IsmatiO.ИсматиО.

resident of distant learning at the department of urology

заочный ординатор кафедры урологии

FGBOU VO North-Western State Medical University named after I.I. MechnikovСеверо-Западный государственный медицинский университет им. И. И. МечниковаCenter of Urology with robot-assisted surgery of City Mariinsky hospitalЦентр урологии с робот-ассистированной хирургией городской Мариинской больницы151020185NO5 (2018)№5 (2018)12813327022023Copyright ©; 2018, Bionika MediaCopyright ©; 2018, ООО «Бионика Медиа»2018Bionika MediaООО «Бионика Медиа»https://journals.eco-vector.com/1728-2985/article/view/296406

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.

В статье представлены основные причины развития инфекционных осложнений перкутанного лечения нефролитиаза, определены предикторы их развития, установленные различными авторами. Проведен обзор исследований, посвященных анализу предоперационных факторов развития после операции лихорадки, синдрома системной воспалительной реакции и/или сепсиса. Установлено, что размер камня и истинная бактериурия служат достоверным фактором их риска развития, на возникновение которых также влияют технические особенности ПНЛи длительность операции. Наличие коралловидного нефролитиаза и множественных камней втрое увеличивает риск развития послеоперационных: осложнений. Послеоперационный сепсис при ПНЛ развивается редко, но является серьезным осложнением и основной причиной летальности в послеоперационном периоде. Применение профилактической антибактериальной терапии с учетом микроорганизмов, высеиваемых из мочевыводящих путей, существенно снижает частоту возникновения послеоперационных инфекционных осложнений. Эффективным считается применение схемы, подразумевающей однократное введение препарата за 30 мин до начала оперативного вмешательства.

urinary stone diseasepercutaneous treatmentnephrolithotomycomplicationsurinary tract infectionssepsisмочекаменная болезньнефролитизперкутанное лечениенефролитотрипсияосложненияинфекция мочевых путейсепсисRomero V., Assimos A. D. G. Kidney stones: a global picture of prevalence, incidence, and associated risk factors. Reviews in Urology. 2010;12:e86-e96.Scales C.D., Jr., Smith A.C., Hanley J.M., Saigal C.S. Prevalence of kidney stones in the United States. Eur. Urol. 2012;62(1):160-165.Каприн А.Д., Аполихин О.И., Сивков А.В., Солцева Е.В., Комарова В.А. Анализ уронефрологической заболеваемости и смертности в Российской Федерации за период 2002-2014 гг. по данным официальной статистики. Экспериментальная и клиническая урология. 2016;3:4-13Preminger G.M., Assimos D.G., Lingeman J.E., Nakada S.Y., Pearle M.S., Wolf J.S. AUA guideline on management of staghorn calculi: diagnosis and treatment recommendations. J. Urol. 2005;173(6):1991-2000.Michel M.S., Trojan L., Rassweiler J.J. Complications in percutaneous nephrolithotomy. Eur. Urol. 2007;51(4):899-906. Doi: 10.1016/j. eururo.2006.10.020.Tefekli A., Karadag M.A., Tepeler K. et al. Classification of percutaneous nephrolithotomy complications using the modified Qavien grading system: looking for a standard. Eur. Urol. 2008;53(1):184-190.Гулиев Б.Г. Осложнения перкутанной нефролитотрипсии. Эндоскопическая хирургия. 2008;1:33-35Seitz C., Desai M., Hacker A. et al. Incidence, prevention and management of complications following percutaneous nephro litholapaxy. Eur. Urol. 2012;61(1):146-158. Doi: 10.1016/j.eururo.2011.09.016.Алексеев М.Ю. Предупреждение и лечение осложнений перкутанной нефролитотрипсии. Автореф. дисс. канд. мед. наук. СПб., 2012, 26 c.Jessen J.P., Honeck P., Knoll T., Wendt-Nordahl G. Percutaneous nephrolithotomy under combined sonographic/radiologic guided puncture: results of a learning curve using the modified Clavien grading system. World J. Urol. 2013;31(6):1599-1603.O’Keeffe N.K., Mortimer A.J., Sambrook P.A., Rao P.N. Severe sepsis following percutaneous or endoscopic procedures for urinary tract stones. Br. J. Urol. 1993;72:277-283.Yang T., Liu S., Hu J., Wang L., Jiang H. The evaluation of risk factors for postoperative infectious complications after percutaneous nephrolithotomy. Biomed. Res. Int. 2017.Sharifi Aghdas F.S., Akhavizadegan H., Aryanpoor A., Inanloo H., Karbakhsh M. Fever after percutaneous nephrolithotomy: contributing factors. Surg. Infectious. 2006;7(4):367-371.Draga R.O., Kok E.T., Sorel M.R., Bosch R.J., Lock T.M. Percutaneous nephrolithotomy: Factors associated with fever after the first postoperative day and systemic inflammatory response syndrome. J. Endourol. 2009;23:921-927.Dogan H.S., Guliyev F., Cetinkaya Y.S., Sofikerim M., Ozden E., Sahin A. Importance of microbiological evaluation in management of infectious complications following percutaneous nephrolithotomy. Int. Urol. Nephrol. 2007;39:737-742.Jou Y.C., Lu C.L., Chen F.H. et al. Contributing factors for fever after tubeless percutaneous nephrolithotomy. Urology. 2015;85:527-530. Doi: 10.1016/j.urology.2014.10.032Koras O., Bozkurt I.H., Yonguc T. et al. Risk factors for postoperative infectious complications following percutaneous nephrolithotomy: A prospective clinical study. Urolithiasis. 2015;43:55-60.Fernandez A., Foell K., Nott L., Denstedt J.D., Razvi H. Percutaneous nephrolithotripsy in patients with urinary diversions: A case-control comparison of perioperative outcomes. J. Endourol. 2011;25:1615-1618.Gonen M., Turan H., Ozturk B., Ozkardes H. Factors affecting fever following percutaneous nephrolithotomy: A prospective clinical study. J. Endourol. 2008;22:2135-2138.Wei W., Leng J., Shao H., Wang W. Diabetes, a risk factor for both infectious and major complications after percutaneous nephrolithotomy. Int. J. Clin. Exp. Med. 2015;8:1620-1626.Dogan HS, Sahin A., Cetinkaya Y., et al. Antibiotic prophylaxis in percutaneous nephrolithotomy: prospective study in 81 patients. J. Endourol. 2002;16:649-653.Olvera-Posada D., Tailly T., Alenezi H. et al. Risk factors for postoperative complications after percutaneous nephrolithotomy (PCNL) in a tertiary referral center. J. Urol. 2015;194:1646-1651.Erdil T., Bostanci Y., Ozden E. et al. Risk factors for systemic inflammatory response syndrome following percutaneous nephrolithotomy. Urolithiasis. 2013;41:395-401.Kumar S., Bag S., Ganesamoni R. et al. Risk factors for urosepsis following percutaneous nephrolithotomy: role of 1 week of nitrofurantoin in reducing the risk of urosepsis. Urol. Res. 2012;40:79-86.Mariappan P., Smith G., Bariol S.V. et al. Stone and pelvic urine culture and sensitivity are better than bladder urine as predictors of urosepsis following percutaneous nephrolithotomy: a prospective clinical study. J. Urol. 2005;173:1610-1614.Lojanapiwat B., Kitirattrakarn P. Role of preoperative and intraoperative factors in mediating infection complication following percutaneous nephrolithotomy. Urol. Int. 2011;86:448-452.Hallmann B., Menzel G., Ruttloff J. Perioperative chemoprophylaxis in percutaneous nephrolitholapaxy. Z. Urol. Nephrol. 1990;83:475-479.Gutierrez J., Smith A., Geavlete P. et al. Urinary tract infections and post-operative fever in percutaneous nephrolithotomy. World J. Urol. 2013;31:1135-1140.Chen L., Xu Q.Q., Li J.X., Xiong L.L., Wang X.F., Huang X.B. Systemic inflammatory response syndrome after percutaneous nephrolithotomy: An assessment of risk factors. Int. J. Urol. 2008;15:1025-1028.Bozkurt I.H., Aydogdu O., Yonguc T., Koras O. et al. Predictive value of leukocytosis for infectious complications after percutaneous nephrolithotomy. Urology. 2015 ; 86( 1) :25-29. Doi: 10.1016/j. urology.2015.04.026.Rivera M., Viers B., Cockerill P., Agarwal D., Mehta R., Krambeck A. Pre-and postoperative predictors of infection-related complications in patients undergoing percutaneous nephrolithotomy. J. Endourol. 2016;30(9):982-986.Bansal S.S., Pawar P. W., Sawant A.S., Ashwin Sunil Tamhankar A.S., Patil S.R., Kasat G.V. Predictive factors for fever and sepsis following percutaneous nephrolithotomy: A review of 580 patients. Urol. Ann. 2017;9(3):230-233.Fan J., Wan S., Liu L., Zhao Z. et al. Predictors for uroseptic shock in patients who undergo minimally invasive percutaneous nephrolithotomy. Urolithiasis. 2017;45(6):573-578. Doi: 10.1007/s00240-017-0963-4Erdil T., Bostanci Y., Ozden E., Atac F. et al. Risk factors for systemic inflammatory response syndrome following percutaneous nephrolithotomy. Urolithiasis. 2013;41(5):395-401.Liu C., Zhang X., Liu Y., Wang P. Prevention and treatment of septic shock following mini-percutaneous nephrolithotomy: a single-center retrospective study of 834 cases. World J. Urol. 2013;31(6);1593-1597.Eswara J.R., Shariftabrizi A., Sacco D. Positive stone culture is associated with a higher rate of sepsis after endourological procedures. Urolithiasis. 2013;41(5):411-414.Shoshany O., Margel D., Finz C., Ben-Yehuda O. et al. Percutaneous nephrolithotomy for infection stones: what is the risk for postoperative sepsis? A retrospective cohort study. Urolithiasis. 2015 ;43(3) :237-242. Doi: 10.1007/s00240-014-0747-zПерепанова Т.С., Зырянов С.К., Соколов А.В., Тищенкова И.Ф. и соавт. Поиск новых режимов антибиотикопрофилактики септических осложнений после перкутанной нефролитотрипсии. Урология. 2014;6:92-95).Seyrek M., Binbay M., Yuruk E., Akman T. et al. Perioperative prophylaxis for percutaneous nephrolithotomy: randomized study concering the drug and dosage. J. Endourol. 2012;26(11):1431-1436.Tuzel E., Aktepe O.C., Akdogan B. Prospective comparative study of two protocols of antibiotic prophylaxis in percutaneous nephrolithotomy. J. Endourol. 2013;27(2):172-176.Mariappan P., Smith G., Moussa S.A., Tolley D.A. One week of ciprofloxacin before percutaneous nephrolithotomy significantly reduces upper tract infection and urosepsis: a prospective controlled study. BJU Int. 2006;98:1075-1079.Bag S., Kumar S., Taneja N. et al. One week of nitrofurantoin before percutaneous nephrolithotomy significantly reduces upper tract infection and urosepsis: a prospective controlled study. Urology. 2011;77:45-49.Gravas S., Montanari E., Geavlete P. et al. Postoperative infection rates in low risk patients undergoing percutaneous nephrolithotomy with and without antibiotic prophylaxis: a matched case control study. J. Urol. 2012;188:843-847.Fourcade R.O. Antibiotic prophylaxis with cefotaxime in endoscopic extraction ofupper urinary tract stones: a randomized study. The Cefotaxime Cooperative Group. J. Antimicrob. Chemother. 1990;26:77-83.Grabe M., Bjerklund-Johansen T.E., Botto H. et al. EAU guidelines on urological infections. 2013.Перепанова Т.С., Голованов С.А., Арустамов Л.Д. Антимикробная профилактика инфекционных камней почек после перкутанной нефролитоторипсии. РМЖ. 2017;27:1987-1991