Evaluation of the effectiveness of dioxydin metaphylaxis of nephrolithiasis in percutaneous nephrolithotripsy
Acta Biomedica, cilt.97, sa.4, 2026 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 97 Sayı: 4
- Basım Tarihi: 2026
- Doi Numarası: 10.23750/abm.2026.19439
- Dergi Adı: Acta Biomedica
- Derginin Tarandığı İndeksler: Scopus, EMBASE
- Anahtar Kelimeler: dioxidine, metaphylaxis, nephrolithiasis, percutaneous nephrolithotomy, stone recurrence
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background and aim. Infectious complications and stone recurrence remain major challenges after percutaneous nephrolithotomy (PCNL) for large kidney stones. This study aimed to evaluate the effectiveness of adjunctive intracavitary 1% dioxidine administration for metaphylaxis of for reducing postoperative infectious complications and stone recurrence following PCNL. Methods. This prospective, randomized, single-blind controlled trial included 95 patients (aged 18–70 years) with kidney stones >2 cm undergoing PCNL. Patients were randomized 1:1 into control (standard systemic ceftriaxone therapy, n=48) and intervention groups (standard therapy plus intracavitary 10 ml 1% dioxidine intraoperatively and on postoperative days 1–2, n=47). Primary outcomes were bacteriuria and leukocyturia at 7 days and 3 months. Secondary outcomes included Clavien–Dindo complications, stone recurrence at 6 months (low-dose CT), laboratory parameters, and stone composition. Results. Intracavitary dioxidine significantly reduced bacteriuria at 7 days (10.6% vs 45.8%, p<0.001) and 3 months (4.3% vs 52.1%, p<0.001). Leukocyturia was markedly lower in the dioxidine group at both time points (p<0.001). Clinically significant complications (Clavien–Dindo ≥II) occurred in 4.3% vs 25.0% (p=0.004), and stone recurrence at 6 months was 4.3% vs 22.9% (p=0.008). Difference-in-Differences analysis confirmed a strong independent effect of dioxidine on urine leukocytes at 1 week (–9.24 ± 2.42, p<0.001) and 3 months (–6.52 ± 2.29, p=0.005). No adverse reactions were observed, and renal function remained stable. Conclusions. Adjunctive intracavitary 1% dioxidine during and after PCNL is a safe and effective strategy for reducing postoperative infectious complications and stone recurrence. Larger multicenter trials are warranted. (www.actabiomedica.it).