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Cirugía y cirujanos
On-line version ISSN 2444-054XPrint version ISSN 0009-7411
Abstract
SIERRA-DIAZ, Erick et al. Incidence of fever and bleeding after percutaneous nephrolithotomy: a prospective cohort study. Cir. cir. [online]. 2022, vol.90, n.1, pp.57-63. Epub Feb 14, 2022. ISSN 2444-054X. https://doi.org/10.24875/ciru.20001130.
Objective:
Despite relative agreement on the need for immediate peri-operative antibiotic prophylaxis in percutaneous nephrolithotomy (PCNL), there is no consensus regarding antibiotic use the days leading up to PCNL. This study aimed to report the incidence of complications during and after PCNL based on a cohort study design.
Material and methods:
We included 101 patients in a prospective schedule for PCNL. Patients were divided into 2 groups. In the exposed patients (positive urine culture) the antibiotic was indicated according to the antibiogram report, 7 days before surgery, and 7 days after surgery, and in the non-exposed patients intravenous antibiotic empirically was administered 8 h and 1 h before surgery.
Results:
The incidence of complications for both groups was 19%. The exposed group presented complications in 27%, and 16% for the non-exposed. The relative risk of complications, in general, was 1.68 (95% CI, 0.77-3.6), the attributable risk was 11.09, and the percentage of attributable risk was 40.68%.
Conclusions:
The presence of positive urine culture is the main risk factor for the development of post-PCNL fever. Each treatment center needs to standardize its protocols to reduce the morbidity associated with surgery and to identify the main risk factors.
Keywords : Percutaneous nephrolithotomy (PCNL); Post-operative fever; Trans-operative bleeding; Antimicrobial prophylaxis; Prospective cohort; Relative risk complications.
