ArticleWorld journal of urology2025
Saturation effect between operation time and post-PCNL SIRS in pediatric patients.
Article in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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5 authors.
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Abstract
backgroundProlonged operation time has been associated with an increased incidence of postoperative complications in various surgical procedures. However, its role in pediatric percutaneous nephrolithotomy (PCNL) remains unclear. This study aimed to investigate the relationship between operation time and systemic inflammatory response syndrome (SIRS) incidence in pediatric patients undergoing PCNL.
methodsThis retrospective study included 472 pediatric patients who underwent PCNL, the primary exposure of interest was operation time, while the primary outcome was the incidence of postoperative SIRS. Multivariate logistic regression, restricted cubic spline (RCS) analysis, and two-piecewise linear regression models were used to assess the relationship and potential threshold effects between operation time and postoperative SIRS. Subgroup analyses were used to investigate the association across different subgroups.
resultsThe median age of the patients was 7 years (interquartile range: 3-12), and 56.36% were male. The median operation time was 80 min (interquartile range: 70-95). Postoperatively, 90 patients developed SIRS, accounting for 19.07% of the total cohort. In the fully adjusted model, compared with the low operation time group, the adjusted odds ratios (95% confidence intervals) for postoperative SIRS were 2.63 (1.20, 5.83) for the medium operation time group and 2.86 (1.28, 6.54) for the high operation time group, respectively. RCS with threshold effect analysis revealed a saturation effect between operation time and postoperative SIRS, with a threshold identified at 70 min. Subgroup analyses indicated that underweight pediatric patients are more susceptible to the effects of operation time.
conclusionProlonged operation time in pediatric patients undergoing PCNL is an independent risk factor for postoperative SIRS, with a non-linear saturation effect relationship and a threshold effect. These findings may contribute to the optimization of surgical strategies for pediatric PCNL aimed at reducing postoperative SIRS.
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