title: Risk factors of systemic inflammation response syndrome after endoscopic combined intrarenal surgery in the modified Valdivia position.
abstract: To identify risk factors of developing systemic inflammation response syndrome after endoscopic combined intrarenal surgery in the modified Valdivia position for renal stone treatment.
  
  
  
  We retrospectively analyzed 370 consecutive patients who underwent endoscopic combined intrarenal surgery procedures in the modified Valdivia position to treat renal stones. Antibiotic therapy based on preoperative urine cultures was administered to all patients from induction of anesthesia until at least postoperative day 3. Postoperative systemic inflammation response syndrome was diagnosed if the patient met two or more systemic inflammation response syndrome criteria. A multivariate logistic regression model with backward selection was used to evaluate the relationships between the incidence of systemic inflammation response syndrome after endoscopic combined intrarenal surgery and other clinical factors.
  
  
  
  Of the 370 patients, 61 patients (16.5%) were diagnosed with systemic inflammation response syndrome after endoscopic combined intrarenal surgery. Significant differences were found between the non-systemic inflammation response syndrome and systemic inflammation response syndrome groups with regard to female sex (29.8% vs 44.3%, P = 0.027), history of febrile urinary tract infection (16.5% vs 32.8%, P = 0.015) and number of involved calyces (2.68 vs 4.1, P < 0.001). Multivariate analysis found three independent predictors of postoperative systemic inflammation response syndrome: the number of involved calyces (P = 0.017), stone surface area (P = 0.021) and history of febrile urinary tract infection (P = 0.005).
  
  
  
  The number of involved calyces larger than four, stone surface area >500 mm(2) and a history of febrile urinary tract infection independently predicted the development of systemic inflammation response syndrome after endoscopic combined intrarenal surgery. This is the first study to identify the independent predictors of systemic inflammation response syndrome after endoscopic combined intrarenal surgery in the modified Valdivia position.
authors.affiliation: Department of Urology, Ohguchi Higashi General Hospital, Yokohama, Kanagawa, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Tabei
authors.affiliation: Department of Urology, Ohguchi Higashi General Hospital, Yokohama, Kanagawa, Japan.|Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ito
authors.affiliation: Department of Urology, Ohguchi Higashi General Hospital, Yokohama, Kanagawa, Japan.
authors.forename: Kimitsugu
authors.initials: K
authors.lastname: Usui
authors.affiliation: Department of Urology, Ohguchi Higashi General Hospital, Yokohama, Kanagawa, Japan.
authors.forename: Shinnosuke
authors.initials: S
authors.lastname: Kuroda
authors.affiliation: Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kawahara
authors.affiliation: Department of Urology, Ohguchi Higashi General Hospital, Yokohama, Kanagawa, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Terao
authors.affiliation: Department of Urology, Ohguchi Higashi General Hospital, Yokohama, Kanagawa, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Fujikawa
authors.affiliation: Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Makiyama
authors.affiliation: Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yao
authors.affiliation: Department of Urology, Ohguchi Higashi General Hospital, Yokohama, Kanagawa, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Matsuzaki
mesh_terms: D005260:Female; D006801:Humans; D007249:Inflammation; D007669:Kidney Calculi / Q000601:surgery*; D008297:Male; D009403:Nephrostomy, Percutaneous; D012189:Retrospective Studies; D012307:Risk Factors; D013577:Syndrome; D016896:Treatment Outcome; D018666:Ureteroscopy
keywords: endoscopic combined intrarenal surgery; lithotripsy; renal stone; risk factor; systemic inflammation response syndrome