Abstract:
PURPOSE:To determine whether a delayed percutaneous nephrolithotomy (PCNL) reduces the rate of bacteremia/sepsis in patients with neuromuscular disorders. Patients with neuromuscular disorders are at higher risk of developing complications after PCNL. One strategy to reduce the risk of infectious complications is to place a percutaneous nephrostomy tube at least 24 h prior to performing PCNL. We analyzed the rates of bacteremia/sepsis in patients with neuromuscular disorders who had access on the day of PCNL (same-day) versus more than 24 h prior to the treatment for the stone (delayed). MATERIALS AND METHODS:We identified 246 consecutive patients who underwent PCNL at our institution between 8/2003 and 8/2008, 35 of whom (14%) had neuromuscular disorders. The primary end point was postoperative bacteremia (fever and positive blood culture) or sepsis (SIRS and documented infection), which was compared between those who had percutaneous access on the day of surgery versus those who had access at least 24 h prior to the operative event. All patients had negative urine cultures preoperatively or were treated with antibiotics for 4-7 days prior to the surgery for a positive preoperative urine culture. RESULTS:The neuromuscular disorders in the 35 patients were multiple sclerosis (16), spina bifida (10), quadriplegia (4), paraplegia/Guillain-Barre (3), and cerebral palsy (2). The rate of bacteremia/sepsis among patients with neuromuscular disorders was 14%. The rate of sepsis/bacteremia was 26% for same-day PCNL versus 0% for delayed PCNL (OR 8.4, p = 0.05). CONCLUSIONS:Delayed PCNL results in lower rates of bacteremia and/or sepsis in patients with neuromuscular disorders.
journal_name
World J Uroljournal_title
World journal of urologyauthors
Eswara JR,Lee H,Dretler SP,Sacco Ddoi
10.1007/s00345-013-1044-0subject
Has Abstractpub_date
2013-12-01 00:00:00pages
1611-5issue
6eissn
0724-4983issn
1433-8726journal_volume
31pub_type
杂志文章abstract:PURPOSE:To compare oncological, functional, and toxicity outcomes of patients with radiation-recurrent prostate cancer (PCa) after external beam radiation therapy (EBRT) or brachytherapy (BT) treated with salvage high-intensity focused ultrasound (S-HIFU) or salvage radical prostatectomy (S-RP). METHODS:This retrospec...
journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-019-02640-x
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abstract::Although immediate radical cystectomy remains the standard of care for invasive bladder cancer, a large body of international experience from single institutions and cooperative groups has accumulated, suggesting favorable results with bladder-sparing approaches in appropriately selected patients. Modern selective bla...
journal_title:World journal of urology
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journal_title:World journal of urology
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journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-013-1220-2
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journal_title:World journal of urology
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journal_title:World journal of urology
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journal_title:World journal of urology
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journal_title:World journal of urology
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更新日期:2017-04-01 00:00:00
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journal_title:World journal of urology
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journal_title:World journal of urology
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pub_type: 杂志文章,多中心研究
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journal_title:World journal of urology
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journal_title:World journal of urology
pub_type: 杂志文章
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journal_title:World journal of urology
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journal_title:World journal of urology
pub_type: 杂志文章
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journal_title:World journal of urology
pub_type: 临床试验,杂志文章
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journal_title:World journal of urology
pub_type: 杂志文章
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更新日期:2020-09-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章
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更新日期:2014-06-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章
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更新日期:2013-08-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章,评审
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更新日期:2019-01-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章
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更新日期:2017-01-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章,评审
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更新日期:2002-04-01 00:00:00