Abstract:Objective To study the influence of residual stones after percutaneous nephrolithotomy (PCNL) on postoperative infection and explore whether positive renal pelvis urine culture (RPUC) and/or stone bacterial culture (SC) could further increase the risk of infection in patients with positive residual stones after PCNL. Methods The clinical data and of 328 patients with renal calculi treated with PCNL in recent 5 years were retrospectively analyzed.The systemic inflammatory response syndrome (SIRS)-related indicators and the residual stone status were observed and recorded for all patients after PCNL.The influences of rsesidual stones with positive bacterial culture and RPUC on postoperative infection were analyzed. Results Postoperative positive SIRS occurred in 48 patients,in whom the proportion of male patients was higher than that of male patients(P=0.039),and the stone load was also higher than that in patients with negative SIRS (P=0.008).Staghorn calculi were the most common in patients with SIRS,while single calculi were the most common in patients without SIRS,but there was no significant difference in it (P=0.117).Compared with patients with negative SIRS,the patients with SIRS required more flushing water during operation,higher blood transfusion and longer hospitalization time (P<0.01).The rate of postoperative residual stone (P=0.004),the positive rate of intraoperative pelvic urine and/or stone culture(P=0.001) in SIRS patients were statistically higher than those in negative SIRS patients.In PCNL patients with positive residual stone,there was no significant difference in the positive rate of pelvic urine and/or stone culture between negative SIRS and positive SIRS patients (P=0.802). Conclusion Positive bacterial culture of residual stones,pelvis urine and/or stones is a risk factor for SIRS after PCNL.However,positive bacterial culture of pelvis urine and/or stones have no superimposed effects on development of SIRS in patients with residual stones after PCNL.