title: Role of preoperative and intraoperative factors in mediating infection complication following percutaneous nephrolithotomy.
abstract: OBJECTIVE
  To identify the pre- and intraoperative factors that affect the development of postoperative systemic inflammatory response syndrome (SIRS) following percutaneous nephrolithotomy (PCNL).
  
  
  METHODS
  A total of 200 patients were treated with PCNL, 56 of which developed postoperative SIRS (group I) and 144 did not (group II). For these 2 groups, the patient factor, operative factor, preoperative urine culture, pelvic urine culture, and stone culture were compared.
  
  
  RESULTS
  Average age, stone size, operative time, success rate, and number of tubeless PCNL were not significantly different between the 2 groups. However, preoperative urine culture, pelvic urine culture, and stone culture, respectively, were positive in 66.1, 46.4 and 48.2% of the patients in group I, but only 10.4, 3.5 and 3.5% for the corresponding specimens in group II. In addition, 5 patients in group I developed clinical septic shock, 4 of which were positive for all cultures and 1 positive only for stone culture.
  
  
  CONCLUSIONS
  Infection following PCNL is common, but only a few cases progress to septic shock. Positive preoperative urine, intraoperative pelvic urine and stone cultures are important factors indicating the development of postoperative SIRS. Intraoperative cultures are important for decision-making about the treatment of postoperative infection complications.
authors.affiliation: Division of Urology, Department of Surgery, Chiang Mai University, Chiang Mai, Thailand. blojanap@mail.med.cmu.ac.th
authors.forename: B
authors.initials: B
authors.lastname: Lojanapiwat
authors.forename: P
authors.initials: P
authors.lastname: Kitirattrakarn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001424:Bacterial Infections / Q000150:complications / Q000209:etiology; D005260:Female; D006801:Humans; D007669:Kidney Calculi; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications; D018805:Sepsis; D012772:Shock, Septic / Q000473:pathology; D018746:Systemic Inflammatory Response Syndrome / Q000503:physiopathology*
chemical_list: D000900:Anti-Bacterial Agents