MP77-20 THE IMPACT OF LONG-TERM ANTIBIOTICS PRIOR TO NEPHRECTOMY FOR XANTHOGRANULOMATOUS PYELONEPHRITIS: MULTICENTER EVALUATION OF OPERATIVE OUTCOMES (2020)

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Kidney & Bladder II (MP77)1 Apr 2020MP77-20 THE IMPACT OF LONG-TERM ANTIBIOTICS PRIOR TO NEPHRECTOMY FOR XANTHOGRANULOMATOUS PYELONEPHRITIS: MULTICENTER EVALUATION OF OPERATIVE OUTCOMES Lillian Xie*, Shlomi Tapiero, Alec R. Flores, Manuel Armas-Phan, Pengbo Jiang, Kamaljot S. Kaler, Rajiv Karani, Kaitlan D. Cobb, Roger L. Sur, Thomas Chi, Jaime Landman, and Ralph V. Clayman Lillian Xie*Lillian Xie* More articles by this author , Shlomi TapieroShlomi Tapiero More articles by this author , Alec R. FloresAlec R. Flores More articles by this author , Manuel Armas-PhanManuel Armas-Phan More articles by this author , Pengbo JiangPengbo Jiang More articles by this author , Kamaljot S. KalerKamaljot S. Kaler More articles by this author , Rajiv KaraniRajiv Karani More articles by this author , Kaitlan D. CobbKaitlan D. Cobb More articles by this author , Roger L. SurRoger L. Sur More articles by this author , Thomas ChiThomas Chi More articles by this author , Jaime LandmanJaime Landman More articles by this author , and Ralph V. ClaymanRalph V. Clayman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000963.020AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Xanthogranulomatous pyelonephritis (XGP) is a destructive bacterial infection and inflammation of the renal parenchyma, typically requiring nephrectomy. We hypothesized that long-term preoperative antibiotics may facilitate a laparoscopic approach with reduced complications by shrinking the kidney and reducing inflammation. METHODS: We reviewed the records of all histologically confirmed XGP patients after nephrectomy at 3 institutions between 2005 and 2018. 61 patients were identified and stratified by antibiotic duration and surgical approach. We compared patients treated with long-term pre-operative antibiotics (≥28 days of continuous treatment until surgery) to patients treated with short-term antibiotics (<28 days). Patient demographics and operative outcomes were analyzed. Complications were assigned by Clavien-Dindo classification. T-test and Chi-square tests were used to evaluate the impact of surgical approach and duration of antibiotics on perioperative outcomes. RESULTS: Among 61 XGP patients, 51 (84%) were female with a mean age of 50 (20-82 years) (Table 1). Median duration of preoperative antibiotics was 11 days (0-228); 24 patients (39%) received long-term antibiotics for a median duration of 64 days (28-298). Patients on long-term antibiotics were more likely to have had drainage tubes preoperatively (nephrostomy tube or perinephric drain) (71% vs. 59%, p=0.02). There was no significant difference in operative time, blood loss, transfusions, and conversion to open surgery between long-term and short-term cohorts. However, among the 40 patients (66%) undergoing laparoscopic surgery, preoperative long-term antibiotics were associated with lower complication rate (47% vs. 89%, p=0.008) and similar length of stay (5 vs. 8 days, p=0.11). CONCLUSIONS: Greater than four weeks of preoperative antibiotics prior to laparoscopic nephrectomy for XGP was associated with fewer postoperative complications which may be assisted by kidney drainage. Source of Funding: N/A © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1171-e1172 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lillian Xie* More articles by this author Shlomi Tapiero More articles by this author Alec R. Flores More articles by this author Manuel Armas-Phan More articles by this author Pengbo Jiang More articles by this author Kamaljot S. Kaler More articles by this author Rajiv Karani More articles by this author Kaitlan D. Cobb More articles by this author Roger L. Sur More articles by this author Thomas Chi More articles by this author Jaime Landman More articles by this author Ralph V. Clayman More articles by this author Expand All Advertisement PDF downloadLoading ...