[Assessment of surgical invasiveness of augmentation ileocystoplasty applying the systemic inflammatory response syndrome score in patients with spina bifida].

PURPOSE Applying the systemic inflammatory response syndrome (SIRS), we investigated the surgical invasiveness of augmentation ileocystoplasty in patients with spina bifida. MATERIALS AND METHODS A total of 23 patients with spina bifida underwent augmentation ileocystoplasty. We diagnosed the cases as SIRS when they fulfilled at least 2 of the 4 SIRS criteria. We developed SIRS score, the sum of the number of positive items for the duration of SIRS, as a parameter of surgical invasiveness. We investigated the relationships between SIRS score and various factors and compared SIRS scores of augmentation with those of other urological operations as a control, which consisted of radical prostatectomy (25 patients) and radical nephrectomy (20 patients). RESULTS We found a positive relationship between SIRS score and the operation time of augmentation. SIRS scores were significantly higher in the patients who underwent operations diverting ventriculoperitoneal shunt to ventriculoatrial shunt concurrently with augmentation. However, the operation times were not significantly different between the cases with and without shunt operations. SIRS scores in cases of augmentation were significantly higher than those of the major urological operations compared. CONCLUSION When evaluated by the SIRS score, the factors related to the surgical invasiveness of augmentation ileocystoplasty were a longer operating time and concurrent shunt diversion. The higher invasiveness of this operation compared with major urological operations was also revealed. These facts should be considered carefully when the indications for augmentation ileocystoplasty are determined.