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\begin{document}

\title{A CUT-OFF VALUE FOR THE OPERATION TIME AND THE OTHER RISK FACTORS IN
TERMS OF THE INFECTION RISK FOR FURS}



\author[1]{Kadir Gunseren}%
\author[2]{Aslan Demir}%
\author[3]{Sinan Çelen}%
\author[4]{Mehmet Çağatay Çiçek}%
\author[4]{Hakan Kılıçarslan}%
\affil[1]{Uludag University}%
\affil[2]{Bezmialem Foundation University Medical Faculty Hospital}%
\affil[3]{Pamukkale Universitesi Tip Fakultesi}%
\affil[4]{Uludağ Üniversitesi Tıp Fakültesi}%


\vspace{-1em}



  
  \date{June 15, 2024}


\begingroup
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\selectlanguage{english}
\begin{abstract}
Objectives To investigate the operation time (OT) and the ureteral
access sheath (UAS) usage with the infection rates and to determine a
cut-off value for OT Methods We retrospectively analyzed the data of the
patients who underwent FURS for renal stones larger than 20 mm between
2010 and 2019. The investigated parameters were OT, UAS using, and
infection status. The data were analyzed by forming two groups according
to whether the OT was less than 60 minutes and more, whether the UAS was
used and whether an infection occurred. In addition, independent risk
factors that may affect postoperative urinary infection development were
also investigated by logistic regression analysis. And, a ROC curve
analysis was applied to determine a cut-off value in OT terms, where
infection rates increase more. Results A total of 575 patients were
enrolled in the study. The rates of the usage UAS and infection were
greater statistically in the group for longer than 60 minutes. OT was
longer statistically in the infection group than in the group without
infection ( 94.1\selectlanguage{ngerman}±14.2 and 68.01±23.1, for groups 1 and 2, respectively,
p\textless{}0.05, Table 2). OT was statistically longer in the UAS group
than unused one ( 79.3±24.4 and 66.7±22.4, for groups 1 and 2,
respectively, p\textless{}0.05, Table 3). ROC analyses revealed a
cut-off point of 87.5min for OT in terms of infection rate Conclusion
While the infection risk increases when OT exceeds 60 minutes, FURS can
be safely performed up to 87.5 minutes with 89\% sensitivity and 69\%
specificity infection risk.%
\end{abstract}\selectlanguage{ngerman}%



\sloppy


\textbf{What is already known about this topic?}

It has been suggested that increased operation time can be associated
with the outcomes of the procedures by increasing complication rates.
Nevertheless, little is known about the time limits. Prolonged operation
times are linked to increased complication rates in ureteroscopy. Stone
complexity, patient risk factors, surgeon experience, bilateral surgery,
and instrumentation are main factors related to the compliactions in
ureteroscopy.

\textbf{What does this article add?}

There are a few studies which have different results about the
complications in terms of the operation time. In order to clarify this
issue further studies are needed. In this context the data about this
matter have been presented in this study. If the optimal operative time
is determined correctly, the risk of infection associated with prolonged
opearation time can be avoided or other relevant measures can be taken.
In this study we aimed to established the optimal operative time by ROC
curve analyses to determine a cutt-off value for the operation time, and
the effect of the ureteral access sheath on this time.

\textbf{Introduction:}

The global prevalence of urolithiasis tends to increase worldwide,
leading to the need for safe and effective treatment
methods\textsuperscript{1}. In parallel with the advances in technology,
flexible ureterorenoscopes, effective lithotripters and innovations in
auxiliary equipment have enabled the treatment most of the renal stones
with flexible ureterorenoscope with no need for open surgery or
percutaneous nephrolithotomy)\textsuperscript{2}. Although the
percutaneous nephrolithotomy (PNL) is recommended as first-line
treatment for renal stones larger than 20 mm in size, flexible
ureterorenoscopy (FURS) or shock wave lithotripsy (SWL) may be
considered as a treatment method for stones larger than 20 mm in size
according to EAU-2019 guideline on urolithiasis especially in case that
PNL is not an option because of other reasons\textsuperscript{3}.

Due to the increasing spread of FURS, it should be addressed in all
aspects, including infection rates. Postoperative infections seem one of
the most common complications of FURS and the parameters that affect
infective complications following FURS were analysed in some studies in
the literature\textsuperscript{4,5}. However, the effect of operation
time (OT) and the relationship of the ureteral access sheath (UAS) with
the infection rates is unclear in this size of renal stones.

We aimed to investigate the relationship of the OT and the UAS usage
with the infection rates and to determine a cut-off value in terms of
OT, where infection rates increase more, by using ROC curve analysis.

\textbf{Material and Method:}

After obtaining the approval of the local ethic committee and the
informed consent from all patients in the study, we retrospectively
analysed the medical records of all the patients who underwent FURS for
renal stones larger than 20 mm in size between 2010 and 2019 in our
tertiary academic centre. All operations were performed after
appropriate antibiotic prophylaxis including second generation
cefalosporine group and confirmation of no bacterial growth in
preoperative urine culture. Patients who have concomitant ureter or
bladder stones, presence of nephrostomy catheter during FURS, renal
abnormality and operated under antibiotic suppression were excluded from
the study.

Postoperative urinary infective complications such as fever,
pyelonephritis and sepsis were investigated. The operated patients who
had the body temperature lasting over 38 degrees for 48 hours or any
body temperature over 39 \selectlanguage{ngerman}°C was considered as infective fever after the
exclusion of postoperative atelectasis. When the infection source
established and the presence of two or more following Systemic
inflammatory response syndrome (SIRS) criteria (body temperature
\textless{} 36 °C or \textgreater{} 38 °C; heart rate \textgreater{} 90
beats/min; respiratory rate \textgreater{} 12/min or PaCO2 \textless{}32
mmHg; white blood cell count \textgreater{} 12,000 or \textless{} 4000/
mm\textsuperscript{3}) determined in that case, it was accepted as
sepsis.

The investigated parameters were age, body mass index (BMI), OT, size,
surface area, density and location of the stones, usage of the UAS, the
presence of the infection and stone free rates. The data were analyzed
by forming two groups according to whether the OT was less than 60
minutes and more, whether the UAS was used and whether an infection
occurred. In addition, independent risk factors that may affect
postoperative urinary infection development were also investigated by
logistic regression analysis. And, a ROC curve analysis was applied to
determine a cut-off value in OT terms, where infection rates increase
more.

Stone characteristics in terms of the size and density of all patients
were evaluated with non-contrast abdominal computed tomography (CT) and
the radio-opacity features of the stones were assessed with
kidney-ureter-bladder (KUB) X-ray graphy, preoperatively. The
longest/total longest diameter of stones was determined as stone size.
Stone surface area was calculated using the formula: length x width x
(\selectlanguage{greek}π\selectlanguage{english}) x 0.25. Residual stones were evaluated with non-contrast abdominal
CT or KUB radiogram in postoperative first month according to opacity of
the stones. OT was defined as the time that passed between the beginning
of the procedure when the device is inserted into the ureteral orifice
and the moment of removing the FURS.

\textbf{Surgical technique}

A semirigid ureteroscopy was performed to cannulate the ureteric orifice
with a safety guidewire (0.035 inch, Microvasive; Boston Scientific
Corp., Natick, MA) and to

perform active dilatation. A 9.5F 45-cm-long UAS (Cook Medical, Inc.,
Bloomington, IN) was placed under fluoroscopic vision in the 114 cases
and while these operations were performed through the UAS, the next 461
cases were operated without using the UAS depending on the case
situation by being evaluating ureteral calibration. A FURS (7.5F;Karl
Storz Flex-X2, Tutlingen, Germany) was also used in all procedures. We
reached the lower pole easily after deflection of the FURS because we
used a 272-lm laser fiber (AMS\_; Sureflex) in all cases. Upon reaching
the stone, a 272-lm laser fiber (AMS; Sureflex) was inserted, and the
stone was fragmented using a holmium:YAG laser (Stonelight\_;
Cooltouch). Some fragmented stones were extracted with stone forceps in
case of using UAS. At the end of the procedure, a double-J stent was
inserted.

\textbf{Systatistical Analysis:}

The results are presented as the mean -- standard deviation (SD). Data
were analyzed using SPSS 22.0 for Windows (SPSS, Inc., Chicago, IL).
Statistical analyses of the means

of continuous variables were performed with the Mann--Whitney U test.
Categorical variables were compared by Chi-Square test. Binary logistic
regression analysis was performed to determine independent risk factors
affecting postoperative urinary infection. The area under the curve
(AUC) of the receiver operating characteristic (ROC) curve was estimated
to evaluate the sensitivity and specificity of the OT in terms of
predicting the infective complications. The best cutoff value was
determined using the Youden index. The AUC, sensitivity, and specificity
were compared using their 95\% confidence intervals (CIs). The results
were considered significant at p\textless{}0.05.

\textbf{Results:}

A total of 575 patients were enrolled into the study. The demographic
characteristics and results of groups in terms of the OT, infection
status and the UAS usage were summarized in Table 1, 2 and 3,
respectively.

According to the analysis with regard to the OT; age, sex, BMI, stone
density, and stone free rates were similar between the groups whose
operation time was less than 60 minutes and the group longer than 60
minutes. As expected, stone size and stone surface area was larger
statistically, than in the group whose OT was longer than 60 minutes
(p\textless{}0.05, Table 1). The rate of the usage UAS was greater
statistically in the group whose OT was longer than 60 minutes
(p\textless{}0.05, Table 1). In addition, infection rates in the group
whose OT was longer than 60 min was higher statistically than in the
group whose OT was lesser than 60 min ( p\textless{}0.05, Table 1).

According to the analysis with regard to the infection status; age, sex,
stone size, stone surface area, localisation of the stones were not
statistically different between the group with the infection and the
group without the infection, but the OT was longer statistically in the
group with the infection than in the group without the infection (
94.1\selectlanguage{ngerman}±14.2 and 68.01±23.1, for the group 1 and 2, respectively,
p\textless{}0.05, Table 2).

According to the analysis with regard to the usage of the UAS; age, sex,
stone size, stone surface area, stone free rates, and infection rates
were not statistically significant between the group in which the UAS
was used and the group not used, however, the OT was statistically
longer in the group in which the UAS was used than in the group in which
the sheath was not used ( 79.3±24.4 and 66.7±22.4, for group 1 and 2,
respectively, p\textless{}0.05, Table 3).

Logistic regression analysis revealed that OT is an independent risk
factor for infective process (Table 4). The analysis of ROC curve to
estimate the sensitivity and specificity of OT in predicting infectious
events determined the cut-off point as 87.5min. The area under curve
(AUC) for OT time in terms of the infection risk was 0.82 (sensitivity
89.3\%, specificity 69.5\%, 95\% CI 0.77-0.88; p=0.000) (Fig.1) (Table
5).

\textbf{Discussion:}

The indications of FURS in the management of urolithiasis has expanded
considerably in recent years thanks to the development related to
technology in terms of miniaturisation and durability of flexible
ureterorenoscope. Therefore, publications on the use of FURS for kidney
stones larger than 20 mm have began to be published in the
literature\textsuperscript{6-8}. Due to being a minimal invasive method,
the choice of the FURS has been increased in the treatment of large
renal stones\textsuperscript{6-8}. Despite reports on the safety of this
operation, severe infective complications, such as sepsis, may occur in
FURS\textsuperscript{9}. For that reason, we believe that the factors
affecting infection should be analyzed in all aspects.

In the literature infective complication rates following FURS change
between 1.7\% and 18.8\% \textsuperscript{4} and it was found as 4.7\%
in consistence with the literature in the present study. Factors that
affect infective complications following FURS were investigated by
various studies\textsuperscript{5-10}. OT is one of the important
factors associated with infective events\textsuperscript{4}. However, in
the treatment of kidney stones larger than 20 mm with FURS, studies that
reported the most appropriate operation time to avoid infective
complications and evaluated the effect of UAS use on these complications
are limited.

According to our results in terms of the OT, it could not established
the statistical difference concerning age, BMI, density, localisation of
the stones and stone free rates between the group lasting less than 60
minutes and the group lasting longer than 60 minutes. In this way, two
homogeneous groups were consisted, and therefore we could more
accurately analyzed the effect of operation time on infective events
following FURS (Table 1). As expected, the stone size and area were
larger statistically in the group lasting longer 60 min than in the
group lasting less than 60 min ( p\textless{}0.05, Table 1). Increased
stone size has the strongest impact on OT\textsuperscript{11}. The OT
was prolong proportionally with the burden of stone in the present
study. According to Sorokin's et al, localisation of stone is another
related factor with OT and it was reported that lower pole stones
increase the OT\textsuperscript{11}. However, contrary to that study,
Jacquemet et al. stated the OT did not differ between lower pole stones
and stones in locations other than lower pole\textsuperscript{12}.
Whereas, according to our results, the stones localised in the renal
pelvis caused longer operation time. The main reason for this situation
may be due to the migration of some fragments to different calyx during
stone fragmentation and the time lost during the search for these
fragments in calyxes of kidney. When the groups formed according to the
OT were compared in terms of infection rates, the infection rates were
found to be significantly lower in the group lasting less than 60
minutes {[} 1(0.3\%) and 27 (9.2\%) for the groups lasting lesser than
60 min and longer than 60 min, respectively, p\textless{}0.05, Table
1{]}. According to the Jung's et al study, with the use of forced
irrigation during ureteroscopy, intrarenal pressure increases above 300
mmHg\textsuperscript{13}. And it was established that according to the
results obtained from some animal and human studies, when intrarenal
pressure rises above 30 mmHg, some defense mechanisms which depend on
the intrarenal pressure including pyelo-tubular, pyelo-venous,
pyelo-sineous and pyelo-lymphatic backflow come into
play\textsuperscript{14-17}. These mechanisms have the potential to
decrease kidney function as well as they may be related to infectious
and hemorrhagic process\textsuperscript{13}. According to our results,
the OT is related to the infectious process. These defense mechanisms,
which initially tried to balance intrarenal pressure with the
compensatory mechanism, create an effect that worsens the situation in
terms of infectious, inflammatory and hemorrhagic processes as the
operation time is prolonged.

When we analysed our data according to the presence of infection, while
there was no statistical difference in terms of age, sex, stone size,
surface area and location parameters. We also evaluated the probable
factors that affecting infective complications following FURS in this
current study. The infection rates were primarily affected by the OT
(Table 2). In the same group, the OT was longer statistically in the
infection group ( 94.1±14.2 and 67.9±23.1 for the groups with and
without infection, respectively, p\textless{}0.05, Table 2). In fact,
this result has been confirmed in our precede analysis according to the
OT by determining the rate of infection statistically significant higher
in the group whose operation time lasts longer than 60 minutes ( Table
1).

A logistic regression analysis was performed in order to determine
independent risk factors affecting post-operative urinary infective
process. In our analysis, the only independent factor affecting the
occurrence of infection in the FURS was the OT (Table 4). In addition to
this analysis, in terms of operation time, we applied the ROC analysis
to determine a cut-off value that facilitates the postoperative risk of
infection and, the cut-off value of OT for the infective process was
found as 87.5 min with 89.3\% sensitivity and 70\% specificity (Table
5). The area under curve (AUC) for OT time was 0.82 ( 95\% CI 0.77-0.88;
p=0.000) (Fig.1). According to this result, in cases the operation time
exceeds 87.5 minutes, a closer follow-up of patients may be recommended
in order not to get worse in terms of infection risk. The earlier
diagnosis means the more effective treatment in case of infection. This
approach may be more important for patients who are at risk in terms of
undergoing anesthesia for the other session. However, if there is no
problem for the patient to receive anesthesia for the second time, the
operation can be terminated by leaving a second session when the
operation time is close to 87.5 minutes by making a decision with the
patient before the operation.

According to our results, the only difference between the groups that
formed in terms of UAS usage was the longer OT in the UAS using group.
(79.3±24.4 and 66.7±22.4, for the groups which used and unused the UAS,
respectively, p \textless{}0.05,Table 3). This time difference depends
on the wasted time because of the extraction of the fragmented parts of
the stone and refocusing to the stone in the kidney. In addition, it was
a striking finding that the infection rate in the group which the UAS
used is not statistically different than the unused group. According to
analysis of this kind of group, although the infection rate in the group
which used the UAS was a bit higher than in the group which unused, this
difference is not significant statistically ( Table 3). But, we
associated this difference with the length of the OT in the group which
used the UAS.

According to the literature, entrance of the bacteria or bacterial
endotoxins into the bloodstream because of the intrarenal backflow due
to elevated intrarenal pressure could be the reason of infective events
following FURS\textsuperscript{4}. Based on this knowledge, the
reduction of the intrarenal pressure constitutes a protection from risk
for bacterial dissemination during stone
fragmentation\textsuperscript{18}. Although it has been reported that
the usage of the UAS reduced the intrarenal pressure in some
literature\textsuperscript{19}, Berardinelli has shown that the absence
of UAS does not increase the risk of post-operative infection rate in
accordance with our results\textsuperscript{10}. In fact, the reduction
of intrarenal pressure due to UAS usage may constitutes a protection for
infective events. According to this theory, we were expecting lower
infection rates in UAS using group. However, increased risk of infection
due to long-term operation seems to had got ahead of the protective
effect of UAS, as shown in table 3. The fact that OT was independently
risk factor in our regression analysis also supports this finding.

In addition, the usage of UAS seems as a two-edged sword; on the one
hand it reduces the intrarenal pressure which might be related with
infective complications, on the other hand it might increase tension
related lesions on the ureter wall\textsuperscript{9}. Thus, Osther et
al had recommended using UAS in case of the indication rather than
routinely\textsuperscript{9}. Since the long-term effects of UAS usage
on the ureter wall are uncertain, we do not prefer to use UAS during
FURS routinely, especially for long-term operations. The protective
effect of using the UAS in terms of the infection risk appears to
decrease as the operation time increases. In the lights of these
findings we believe that FURS without using UAS could be perform without
an increased risk in terms of infective complications.

\textbf{Limitations of the study:}

Lack of stone analysis is one of the limitations of the study.

\textbf{Conclusion:}

In kidney stones larger than 2 cm, the most important parameter
determining the benefit of the UAS and general infective complications
in terms of infective process is the operation time. While the risk of
infection increases when the operation time exceeds 60 minutes, FURS can
be safely performed up to 87.5 minutes in terms of infection risk, with
89\% sensitivity and 69\% specificity.

\textbf{Acknowledegements:} None

\textbf{Conflicts of interest:} The authors have declared that they have
no conflicts of interest.

\textbf{Funding:} None

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19. Auge BK, Pietrow PK, Lallas CD, et al. Ureteral access sheath
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\begin{longtable}[]{@{}lllll@{}}
\toprule
\begin{minipage}[b]{0.17\columnwidth}\raggedright\strut
Parameters\strut
\end{minipage} & \begin{minipage}[b]{0.17\columnwidth}\raggedright\strut
Parameters\strut
\end{minipage} & \begin{minipage}[b]{0.17\columnwidth}\raggedright\strut
OPERATION TIME\strut
\end{minipage} & \begin{minipage}[b]{0.17\columnwidth}\raggedright\strut
OPERATION TIME\strut
\end{minipage} & \begin{minipage}[b]{0.17\columnwidth}\raggedright\strut
OPERATION TIME\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
[?]60 min n=289\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
\textgreater{}60 min n=286\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
p\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Age\textsuperscript{*}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Age\textsuperscript{*}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
49,9\selectlanguage{ngerman}±16,0\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
50,3\selectlanguage{ngerman}±15,5\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,943\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Sex\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Woman: (\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
116 (40,1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
121 (42,3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,597\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Man: n (\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
173 (59,9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
165 (57,7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
BMI\textsuperscript{*}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
BMI\textsuperscript{*}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
27,8\selectlanguage{ngerman}±5,6\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
28,3\selectlanguage{ngerman}±6,1\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,559\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Stone size (mm)\textsuperscript{*}}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Stone size (mm)\textsuperscript{*}}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\selectlanguage{ngerman}\textbf{24,4±6,1}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\selectlanguage{ngerman}\textbf{30,2±9,4}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{0,000}\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Stone area (mm\textsuperscript{2})\textsuperscript{*}}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Stone area (mm\textsuperscript{2})\textsuperscript{*}}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\selectlanguage{ngerman}\textbf{181±47}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\selectlanguage{ngerman}\textbf{217,4±77}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{0,000}\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Density (HU)\textsuperscript{*}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Density (HU)\textsuperscript{*}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
963\selectlanguage{ngerman}±399\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
896\selectlanguage{ngerman}±421\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,229\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Stone free rate, n(\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Stone free rate, n(\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
242(83,7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
236(82,5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,696\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Upper pole, n(\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Upper pole, n(\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
42(14,5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
47(15,5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,529\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Middle portion, n(\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Middle portion, n(\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
79(27,3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
80 (28,0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,865\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Lower pole, n(\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Lower pole, n(\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
152(52,6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
155(54,2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,700\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Pelvis, n(\%)}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Pelvis, n(\%)}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{97(33,6\%)}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{121(42,3\%)}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{0,031}\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Infection rates, (\%)}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Infection rates, (\%)}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{1(0,3\%)}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{27(9,4\%)}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{0,000}\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{UAS usage, n(\%)}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{UAS usage, n(\%)}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{37(12,8\%)}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{77(26,9\%)}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{0,000}\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

Table 1: The demographic characteristics and results according to
operation time

\textsuperscript{*}the mean\selectlanguage{ngerman}±standard deviations value

P\textless{}0.05; statistical significance\selectlanguage{english}
\begin{longtable}[]{@{}lllll@{}}
\toprule
\begin{minipage}[b]{0.17\columnwidth}\raggedright\strut
Parameters\strut
\end{minipage} & \begin{minipage}[b]{0.17\columnwidth}\raggedright\strut
Parameters\strut
\end{minipage} & \begin{minipage}[b]{0.17\columnwidth}\raggedright\strut
INFECTION STATUS\strut
\end{minipage} & \begin{minipage}[b]{0.17\columnwidth}\raggedright\strut
INFECTION STATUS\strut
\end{minipage} & \begin{minipage}[b]{0.17\columnwidth}\raggedright\strut
INFECTION STATUS\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
(+) n=28 (4.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
(-) n=547 (95.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
p\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Age\textsuperscript{*}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Age\textsuperscript{*}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
52,1\selectlanguage{ngerman}±13,3\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
50\selectlanguage{ngerman}±15,9\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,690\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Sex\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Woman: n (\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{16 (57.1\%)}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
220\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{0,076}\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Man: n (\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{12 (42.9\%)}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
327\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
BMI\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
BMI\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
30,1\selectlanguage{ngerman}±7,8\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
27,9\selectlanguage{ngerman}±5,7\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,197\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{OT\textsuperscript{*}}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{OT\textsuperscript{*}}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\selectlanguage{ngerman}\textbf{94,1±14,2}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\selectlanguage{ngerman}\textbf{67,9±23,1}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{0,000}\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Stone size\textsuperscript{*}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Stone size\textsuperscript{*}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
27,2\selectlanguage{ngerman}±9\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
27,3\selectlanguage{ngerman}±8,4\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,658\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Stone area\textsuperscript{*}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Stone area\textsuperscript{*}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
189,8\selectlanguage{ngerman}±72\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
199\selectlanguage{ngerman}±66,8\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,305\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Density\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Density\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
851\selectlanguage{ngerman}±374\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
931,7\selectlanguage{ngerman}±414\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,513\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Stone Free Rate\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Stone Free Rate\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
26 (92,6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
452 (82,6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,159\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Upper pole\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Upper pole\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
4 (14,3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
87 (15,5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,858\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Middle portion\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Middle portion\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
9 (32,1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
150 (27,4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,586\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Lower pole\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Lower pole\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
10 (35,7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
297 (54,3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,055\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Pelvis\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Pelvis\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
12 (42,9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
206 (37,7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,580\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Access sheath usage\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Access sheath usage\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
9 (32,1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
105 (19,2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,094\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

Table 2: The demographic characteristics and results according to the
infection status

\textsuperscript{*}The mean \selectlanguage{ngerman}±Standard deviation value

P\textless{}0.05; statistical significance

Table 3: The demographic characteristics and results according to the
usage of the UAS

\textsuperscript{*}The mean±standard deviations, P\textless{}0.05;
statistical significance\selectlanguage{english}
\begin{longtable}[]{@{}lllll@{}}
\toprule
\begin{minipage}[b]{0.17\columnwidth}\raggedright\strut
Parameters\strut
\end{minipage} & \begin{minipage}[b]{0.17\columnwidth}\raggedright\strut
Parameters\strut
\end{minipage} & \begin{minipage}[b]{0.17\columnwidth}\raggedright\strut
UAS USAGE\strut
\end{minipage} & \begin{minipage}[b]{0.17\columnwidth}\raggedright\strut
UAS USAGE\strut
\end{minipage} & \begin{minipage}[b]{0.17\columnwidth}\raggedright\strut
UAS USAGE\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
UAS ( +) n=114 (19.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
UAS (-) n=461 (80.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
p\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Age\textsuperscript{*}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Age\textsuperscript{*}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
52,6\selectlanguage{ngerman}±13,7\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
49,5\selectlanguage{ngerman}±16,2\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,290\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Sex\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Woman: n (\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
49 (43\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
188 (40,8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,669\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Man n: (\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
65 (57\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
273 (59,2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
BMI\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
BMI\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
29\selectlanguage{ngerman}±5,7\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
27,8\selectlanguage{ngerman}±5,8\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,046\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{OT\textsuperscript{*}}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{OT\textsuperscript{*}}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\selectlanguage{ngerman}\textbf{79,4±24,5}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\selectlanguage{ngerman}\textbf{66,7±22,5}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{0,000}\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Stone size\textsuperscript{*}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Stone size\textsuperscript{*}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
27,5\selectlanguage{ngerman}±7,9\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
27,3\selectlanguage{ngerman}±8,5\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,342\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Stone area\textsuperscript{*}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Stone area\textsuperscript{*}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
198,3\selectlanguage{ngerman}±70\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
199,3\selectlanguage{ngerman}±66\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,603\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Density\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Density\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
797,6\selectlanguage{ngerman}±405\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
977,8\selectlanguage{ngerman}±404\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,004\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Stone Free Rate\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Stone Free Rate\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
382 (82,9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
96 (84,2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,731\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Upper pole\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Upper pole\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
20 (17,5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
69 (15\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,496\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Middle portion\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Middle portion\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
36 (31,6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
123 (26,7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,295\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Lower pole\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Lower pole\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
68 (59,6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
239 (51,8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,135\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Pelvis}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Pelvis}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{34 (29,8\%)}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{184 (39,9\%)}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{0,047}\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Infection rates\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Infection rates\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
9(7,9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
19(4,1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0,094\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}\selectlanguage{english}
\begin{longtable}[]{@{}llll@{}}
\toprule
Factor & B & OR (95\%CI) & p\tabularnewline
\midrule
\endhead
Age & 0,036 & 1,03 (0,98:1,08) & 0,149\tabularnewline
Sex (ref,cat:woman) & -0,254 & 0,77 (0,16:3,56) & 0,744\tabularnewline
BMI & 0,042 & 1,04 (0,91:1,18) & 0,515\tabularnewline
\textbf{Operation Time} & \textbf{0,069} & \textbf{1,07 (1,02:1,12)} &
\textbf{0,002}\tabularnewline
Stone Size & 0,077 & 1,08 (0,92:1,26) & 0,333\tabularnewline
Stone Area & -0,007 & 0,99 (0,97:1,01) & 0,413\tabularnewline
Density & 0,000 & 1,00 (0,99:1,00) & 0,784\tabularnewline
Stone Free Rate (ref,cat:none) & -1,239 & 0,29 (0,02:3,52) &
0,331\tabularnewline
Upper Pole (ref,cat:none) & -0,704 & 0,49 (0,06:3,91) &
0,505\tabularnewline
Middle Pole (ref,cat:none) & 0,196 & 1,21 (0,21:6,98) &
0,826\tabularnewline
Lower Pole (ref,cat:none) & -1,381 & 0,25 (0,03:1,67) &
0,153\tabularnewline
Pelvis (ref,cat:none) & -1,060 & 0,34 (0,39:3,06) & 0,341\tabularnewline
Access Sheath (ref,cat:none) & 1,054 & 2,86 (0,61:13,35) &
0,179\tabularnewline
\bottomrule
\end{longtable}

\textbf{Table 4:} Independing risk factors effecting postoperative
urinary infective process by binary logistic regression (n:576; none
infection{[}+{]}=548, infection {[}+{]}=28)\selectlanguage{english}
\begin{longtable}[]{@{}lll@{}}
\toprule
\textbf{Operation Time} & \textbf{Sensitivity} &
\textbf{Specificity}\tabularnewline
\midrule
\endhead
29,000 & 1,00 & 0,00\tabularnewline
37,500 & 1,00 & 0,09\tabularnewline
48,500 & 1,00 & 0,24\tabularnewline
57,500 & 1,00 & 0,29\tabularnewline
67,500 & 0,96 & 0,53\tabularnewline
77,500 & 0,89 & 0,66\tabularnewline
\textbf{87,500} & \textbf{0,89} & \textbf{0,70}\tabularnewline
97,500 & 0,32 & 0,92\tabularnewline
107,500 & 0,18 & 0,95\tabularnewline
115,000 & 0,14 & 0,96\tabularnewline
127,500 & 0,00 & 1,00\tabularnewline
142,500 & 0,00 & 1,00\tabularnewline
151,000 & 0,00 & 1,00\tabularnewline
\bottomrule
\end{longtable}

\textbf{Table 5:} The sensitivity and specificity rates of the cut-off
value for the operation time in terms of the infection risk

\textbf{Figure 1:} ROC curve analysis to estimate infective process
using operation time\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Figure-1/Figure-1}

\end{center}
\end{figure}

\selectlanguage{english}
\FloatBarrier
\end{document}

