Purpose

To identify risk factors by developing and internally validating a nomogram for preventing perioperative complications in overnight ureteral catheterization cases after fURS for kidney stones.

Methods

We retrospectively examined 309 patients with overnight ureteral catheterization after single fURS procedures for renal stones. fURS procedures were performed based on the fragmentation technique. The ureteral catheter was removed on postoperative day 1. Within this group, patients who experienced perioperative complications (complication group) were compared with those who did not experience complications (non-complication group). The complication group included 77 patients whose Clavien–Dindo classification score was I, II, III, or IV and/or those whose body temperature during hospitalization was over 37.5 °C.

Results

The overall stone volume, stone-free rate, incidence of perioperative complications, and procedure duration were 1.39 mL, 94.8%, 24.9%, and 62 min, respectively. Severe complications of a Clavien–Dindo level III or IV were observed in only four cases (1.3%). Multivariate assessment revealed five independent predictors of perioperative complications after fURS with overnight catheterization: age (p = 0.11), sex (p = 0.067), stone volume (p = 0.33), Hounsfield units (p = 0.16), and narrow ureter (p = 0.018). We developed a nomogram to predict perioperative complications after fURS using these parameters.

Conclusions

We developed a predictive model for perioperative complications of patients with overnight catheterization after fURS for renal stones. This model could select patients who were at a low risk of complications.

中文翻译：

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开发和内部验证诺模图，以预测输尿管通宵插管情况下输尿管镜检查对肾结石的围手术期并发症。

目的

通过开发和内部验证诺模图的危险因素，以防止fURS肾结石后输尿管通宵过夜的围手术期并发症。

方法

我们回顾性分析了单次fURS手术后肾结石的309例输尿管通宵通宵的患者。基于碎片技术执行fURS程序。术后第1天拔除输尿管导管。在该组中，将发生围手术期并发症的患者（并发症组）与未发生并发症的患者（非并发症组）进行比较。并发症组包括77例Clavien-Dindo分类评分​​为I，II，III或IV和/或住院期间体温超过37.5°C的患者。

结果

总结石量，无结石率，围手术期并发症发生率和手术时间分别为1.39 mL，94.8％，24.9％和62分钟。仅在四例中观察到了Clavien-Dindo III或IV级的严重并发症（1.3％）。多变量评估显示了通宵进行导管插入的fURS术后围手术期并发症的五个独立预测因子：年龄（p  = 0.11），性别（p  = 0.067），结石体积（p  = 0.33），Hounsfield单位（p  = 0.16）和输尿管狭窄（p  = 0.018）。我们使用这些参数开发了诺模图来预测fURS术后的围手术期并发症。

结论

我们建立了fURS肾结石术后通宵插管患者围手术期并发症的预测模型。该模型可以选择并发症风险较低的患者。