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Uso de la funda de acceso ureteral y hospitalizaciones relacionadas con infecciones: patrones de práctica y

Russell E N Becker1, Suprita Krishna1, Andrew M Higgins2

  • 1University of Michigan, Ann Arbor, Michigan, United States.

Urology practice
|December 15, 2025
PubMed
Resumen

El uso de la funda de acceso ureteral (UAS) durante la ureteroscopia (URS) para cálculos renales varía ampliamente. Este estudio no encontró diferencias significativas en las hospitalizaciones relacionadas con infecciones con o sin UAS, lo que sugiere que otros factores influyen en los resultados del paciente.

Palabras clave:
funda de acceso ureteralinfecciónsepsisureteroscopiainfección del tracto urinario

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Área de la Ciencia:

  • Urología
  • Innovación Quirúrgica
  • Control de Infecciones

Sus antecedentes:

  • La ureteroscopia (URS) es un procedimiento común para el tratamiento de cálculos renales.
  • El uso de una funda de acceso ureteral (UAS) durante la URS se debate en cuanto a su impacto en las tasas de infección.
  • La comprensión de los factores que influyen en las hospitalizaciones relacionadas con infecciones es crucial para la seguridad del paciente.

Objetivo del estudio:

  • Comparar las tasas de hospitalización relacionadas con infecciones entre URS con y sin UAS para cálculos renales.
  • Identificar los factores de riesgo asociados con las hospitalizaciones relacionadas con infecciones durante la URS.
  • Evaluar la variación en el uso de UAS en diferentes prácticas quirúrgicas.

Principales métodos:

  • Análisis del registro Michigan Urological Surgery Improvement Collaborative (MUSIC).
  • Inclusión de pacientes sometidos a URS unilateral en una sola etapa para cálculos renales.
  • Regresión logística multivariable para evaluar el uso de UAS y los factores clínicos en la hospitalización relacionada con infecciones a 30 días.

Principales resultados:

  • Un total de 6.142 pacientes se sometieron a URS, y el 2,5% experimentó hospitalización relacionada con infecciones en los 30 días posteriores.
  • Se utilizó UAS en el 59% de los casos, mostrando una variación significativa en la práctica (4,1% a 99,5%).
  • Las tasas de hospitalización relacionadas con infecciones fueron similares con (2,6%) y sin (2,3%) el uso de UAS (p=0,5).
  • Los factores de riesgo de hospitalización incluyeron un mayor índice de comorbilidad de Charlson, infecciones del tracto urinario recurrentes, cálculos más grandes y análisis/cultivo de orina preoperatorio positivo.

Conclusiones:

  • El uso de la funda de acceso ureteral en la URS para cálculos renales varía significativamente entre las prácticas.
  • El uso de UAS no se asoció con una reducción en las hospitalizaciones relacionadas con infecciones a 30 días.
  • Se justifica una mayor investigación sobre la presión intrarenal durante la URS para comprender las implicaciones de la infección.