Nephrolithiasis, Postoperative Inflammation
Conditions
Keywords
Percutaneous Nephrolithotomy, PCNL, Spinal Anesthesia, General Anesthesia, Inflammatory Response, Neutrophil-to-Lymphocyte Ratio (NLR), Red Cell Distribution Width (RDW), Lactate-to-Albumin Ratio (LAR)
Brief summary
This observational study compares the effects of spinal versus general anesthesia on the perioperative systemic inflammatory response in adults undergoing PCNL. Routine clinical laboratory values (NLR, RDW, LAR) obtained preoperatively and postoperatively will be recorded to evaluate between-group and within-group changes. No additional blood sampling will be performed beyond standard care.
Detailed description
The study will be conducted at the Department of Anesthesiology and Reanimation, Elazığ Fethi Sekin City Hospital, among adult patients scheduled for PCNL (ASA I-III). The anesthesia type (spinal vs general) is determined by clinical requirements; investigators do not influence this choice. Sampling windows: Preoperative: within ≤6 hours before surgery Postoperative: first sample obtained within 6-24 hours after surgery Parameters: NLR (neutrophil/lymphocyte), RDW, LAR; plus age, sex, ASA class, operative time, and in-hospital complications. Statistics: Normality testing; between-group comparisons by independent t-test or Mann-Whitney U; within-group by paired t-test or Wilcoxon; categorical by chi-square; p\<0.05 significant. Power considerations target ≥45 per group (total ≥90). No extra biospecimens will be collected beyond routine care.
Interventions
OTHERAnesthesia Type
Patients receive either spinal or general anesthesia according to routine clinical decision-making. No investigational drug or device is administered.
Sponsors
Sevim Şenol Karataş
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
Age ≥18 years ASA physical status I-III Scheduled for percutaneous nephrolithotomy (PCNL) Provided informed consent
Exclusion criteria
Active infection or sepsis Known malignancy Chronic inflammatory or autoimmune disease (e.g., rheumatoid arthritis, systemic lupus erythematosus) Current immunosuppressive therapy Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Neutrophil-to-Lymphocyte Ratio (ΔNLR) | Baseline (≤6 hours preoperative) and 24 hours postoperatively | Difference in neutrophil-to-lymphocyte ratio (NLR) between preoperative (≤6 hours before surgery) and postoperative (6-24 hours after surgery) blood samples in spinal vs general anesthesia groups. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Red Cell Distribution Width (ΔRDW) | Baseline (≤6 hours preoperative) and 24 hours postoperatively | Difference in RDW values between preoperative (≤6 hours before surgery) and postoperative (6-24 hours after surgery) blood samples in spinal vs general anesthesia groups. |
| Change in Lactate-to-Albumin Ratio (ΔLAR) | aseline (≤6 hours preoperative) and 24 hours postoperatively | Difference in LAR values between preoperative (≤6 hours before surgery) and postoperative (6-24 hours after surgery) blood samples in spinal vs general anesthesia groups. |
| Postoperative Complications | From surgery until hospital discharge (up to 7 days) | Occurrence of any PCNL-related complications (e.g., bleeding, infection) during index hospitalization. |
Countries
Turkey (Türkiye)
Outcome results
None listed