[Sportschosun Jang Jong-ho] A research paper on endoscopic surgery for urinary stones, led by Cha Han-gyu, a professor in the Urology Department at Gangdong Sacred Heart Hospital and first author, has been published in the international journal Journal of Endourology.
The study has drawn attention for proposing a practical surgical standard aimed at reducing infectious complications that can occur after endoscopic surgery for urinary stones.
Cha focused on the size ratio between the endoscope and the sheath used in endoscopic surgery for urinary stones. The findings showed that when the endoscope occupied too much of the sheath’s interior, urine and irrigation fluid could not drain smoothly. This raised pressure inside the kidney and could allow bacteria or toxins to enter the bloodstream, increasing the risk of infectious complications.
The study found that the infection rate was 14.6% in patients whose residual endoscope-to-sheath diameter ratio (RESD) exceeded 0.85, significantly higher than the 4.1% rate in patients with an RESD of 0.85 or lower. Based on this, the research team proposed 0.85 as a clinical threshold linked to increased infection risk. By contrast, the 0.75 standard suggested in earlier experimental studies did not clearly distinguish infection risk in real-world clinical data.
The results showed that a higher size ratio between the endoscope and sheath was associated with a greater risk of postoperative infection. Patients in whom bacteria were detected in the stone were also found to have a higher likelihood of infectious complications. The team explained that, to reduce postoperative infections, it is important not only to remove the stone but also to prevent excessive pressure buildup inside the kidney during surgery and to consider whether the stone contains infection.
Cha said, "This study confirmed through real patient data that the combination of instruments used in endoscopic surgery for urinary stones is closely related to the risk of postoperative infection," adding, "Managing intraoperative kidney pressure so that it does not rise excessively will help prevent infection and improve patient safety."
He added, "The existing 0.75 standard had meaning in experimental settings, but it was often difficult to apply in actual surgical practice," and explained, "The 0.85 threshold proposed in this study can serve as a more practical indicator for clinical use."
The study was a multicenter analysis of patients who underwent surgery at Gangneung Asan Hospital and Gangdong Sacred Heart Hospital. It is significant because it compared patient groups treated with the same surgical methods and treatment standards, improving the reliability of the findings.
Jang Jong-ho bellho@sportschosun.com
