title: Comparison of renal pelvic pressure and postoperative fever incidence between standard- and mini-tract percutaneous nephrolithotomy.
abstract: This study was proposed to compare the clinical effectiveness of mini-tract percutaneous nephrolithotomy (MPCNL) with standard-tract percutaneous nephrolithotomy (SPCNL) and verify whether MPCNL is associated with both higher renal pelvic pressure (RPP) and incidence of postoperative fever. A total of 228 patients with kidney stone were randomly allocated to the MPCNL group (n=114) and SPCNL group (n=114). Both intraoperative and postoperative indexes along with the incidence of complications were compared between the two treatment groups. RPP was measured using a baroreceptor which was connected to an open-ended ureteric catheter during the operation of percutaneous nephrolithotomy. The MPCNL group exhibited significantly longer average operation time, more average amount of flush water, and lesser average amount of bleeding during the operation than the SPCNL group (p<0.05). Moreover, significantly lesser average amount of postoperative serum creatinine, shorter average hospital stay, and more average amount of postoperative hemoglobin were observed in the MPCNL group than in the SPCNL group (p<0.05). MPCNL were more applicable to clear caliceal stones (p<0.05), whereas SPCNL were more effective for the removal of simple pelvic stones. The difference in the incidence of postoperative fever between the two treatment groups also appeared to be significant (p<0.05). Logistic regression provided solid evidence that both RPP and its accumulation time at which RPP≥30 mmHg significantly affected the incidence of postoperative fever. MPCNL was correlated with both higher RPP and increased likelihood of postoperative fever compared with SPCNL.
authors.affiliation: Department of Urology, DongTai People's Hospital, Dongtai Affiliated Hospital of Nantong University, Dongtai, Jiangsu, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Wu
authors.affiliation: Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
authors.forename: Li-Xin
authors.initials: LX
authors.lastname: Hua
authors.affiliation: Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
authors.forename: Jian-Zhong
authors.initials: JZ
authors.lastname: Zhang
authors.affiliation: Department of Urology, DongTai People's Hospital, Dongtai Affiliated Hospital of Nantong University, Dongtai, Jiangsu, China.
authors.forename: Xun-Rong
authors.initials: XR
authors.lastname: Zhou
authors.affiliation: Department of Urology, China Meitan General Hospital, Beijing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhong
authors.affiliation: Department of Urology, DongTai People's Hospital, Dongtai Affiliated Hospital of Nantong University, Dongtai, Jiangsu, China. Electronic address: nihaodon_g@yeah.net.
authors.forename: Hao-Dong
authors.initials: HD
authors.lastname: Ni
mesh_terms: D000328:Adult; D003404:Creatinine / Q000097:blood; D005260:Female; D005334:Fever / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007669:Kidney Calculi / Q000097:blood / Q000473:pathology / Q000601:surgery*; D007682:Kidney Pelvis / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D007902:Length of Stay / Q000706:statistics & numerical data; D008096:Lithotripsy / Q000295:instrumentation / Q000379:methods*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D009403:Nephrostomy, Percutaneous / Q000295:instrumentation / Q000379:methods*; D061646:Operative Time; D011183:Postoperative Complications / Q000503:physiopathology*; D011312:Pressure; D012189:Retrospective Studies
chemical_list: D006454:Hemoglobins; D003404:Creatinine
keywords: Kidney calculi; Mini-tract; Percutaneous nephrolithotomy; Postoperative fever; Standard-tract