Does renal parenchymal thickness affect bleeding in percutaneous nephrolithotomy?

Blood loss is a major concern during percutaneous nephrolithotomy. The aim of this study was to evaluate the effect of access point parenchymal thickness on bleeding in percutaneous nephrolithotomy procedures. Materials and methods: In this study 85 patients who had undergone a percutaneous nephrolithotomy operation between February 2009 and July 2011 were reviewed retrospectively. All characteristics of the patients were investigated. The details of the operative procedure and the renal parenchymal thickness at the puncture site were also recorded. Blood loss was calculated during the peroperative and postoperative periods. Correlation and multivariate regression analysis were done to detect predictive factors on bleeding. Results: Of the 85 percutaneous nephrolithotomy procedures done, 12 (14.1%) patients had no diminution of hemoglobin value postoperatively and were excluded. This left 73 percutaneous nephrolithotomy procedures that were evaluated. The mean peroperative hemoglobin drop was 1.79 ± 1.17 mg/dL. Stone size, operation time, and grade of hydronephrosis were correlated with hemoglobin drop significantly (P = 0.047, P = 0.016, and P = 0.034, respectively). There was no correlation between parenchymal thickness and bleeding (P = 0.545). In multivariate regression analysis, only the operation time was found to be a statistically significant independent predictive factor for peroperative bleeding in percutaneous nephrolithotomy (P = 0.005). Conclusion: Renal parenchymal thickness and the grade of hydronephrosis do not predict peroperative hemorrhage in percutaneous nephrolithotomy procedures.

Does renal parenchymal thickness affect bleeding in percutaneous nephrolithotomy?

Blood loss is a major concern during percutaneous nephrolithotomy. The aim of this study was to evaluate the effect of access point parenchymal thickness on bleeding in percutaneous nephrolithotomy procedures. Materials and methods: In this study 85 patients who had undergone a percutaneous nephrolithotomy operation between February 2009 and July 2011 were reviewed retrospectively. All characteristics of the patients were investigated. The details of the operative procedure and the renal parenchymal thickness at the puncture site were also recorded. Blood loss was calculated during the peroperative and postoperative periods. Correlation and multivariate regression analysis were done to detect predictive factors on bleeding. Results: Of the 85 percutaneous nephrolithotomy procedures done, 12 (14.1%) patients had no diminution of hemoglobin value postoperatively and were excluded. This left 73 percutaneous nephrolithotomy procedures that were evaluated. The mean peroperative hemoglobin drop was 1.79 ± 1.17 mg/dL. Stone size, operation time, and grade of hydronephrosis were correlated with hemoglobin drop significantly (P = 0.047, P = 0.016, and P = 0.034, respectively). There was no correlation between parenchymal thickness and bleeding (P = 0.545). In multivariate regression analysis, only the operation time was found to be a statistically significant independent predictive factor for peroperative bleeding in percutaneous nephrolithotomy (P = 0.005). Conclusion: Renal parenchymal thickness and the grade of hydronephrosis do not predict peroperative hemorrhage in percutaneous nephrolithotomy procedures.

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  • Preminger GM, Assimos DG, Lingeman JE, Nakada SY, Pearle MS, Wolf JS Jr. Chapter 1: AUA guideline on management of staghorn calculi: diagnosis and treatment recommendations. J Urol; 173: 1991–2000.
  • Segura JW, Patterson DE, LeRoy AJ, Williams HJ Jr, Barrett DM, Benson RC Jr et al. Percutaneous removal of kidney stones: review of 1000 cases. J Urol; 134: 1077–81. el-Kenawy MR, el-Kappany HA, el-Diasty TA, Ghoneim MA. Percutaneous nephrolithotripsy for renal stones in over 1000 patients. Br J Urol 1992; 69: 470–5.
  • Lee WJ, Smith AD, Cubelli V, Badlani GH, Lewin B, Vernace F et al. Complications of percutaneous nephrolithotomy. Am J Roentgenol 1987; 148: 177–80.
  • Kukreja R, Desai M, Patel S, Bapat S, Desai M. Factors affecting blood loss during percutaneous nephrolithotomy: prospective study. J Endourol 2004; 18: 715–22.
  • Turna B, Nazli O, Demiryoguran S, Mammadov R, Cal C. Percutaneous nephrolithotomy: variables that influence hemorrhage. Urology 2007; 69: 603–7.
  • Rassweiler JJ, Renner C, Eisenberger F. The management of complex renal stones. BJU Int 2000; 86: 919–28.
  • Fernbach SK, Maizels M, Conway JJ. Ultrasound grading of hydronephrosis: introduction to the system used by the Society for Fetal Urology. Pediatr Radiol 1993; 23: 478–80.
  • Atmaca AF, Canda AE, Özdemir AT, Şerefoğlu EC, Doğan B, Balbay MD. Comparison of outcomes of percutaneous nephrolithotomy on patients with normal and malformed kidneys. Turk J Med Sci 2009; 39: 599–605.
  • Galek L, Darewicz B, Werel T, Darewicz J. Haemorrhagic complications of percutaneous lithotripsy: original methods of treatment. Int Urol Nephrol 2000; 32: 231–3.
  • Kaye KW, Clayman RV. Tamponade nephrostomy catheter for percutaneous nephrostolithotomy. Urology 1986; 27: 441–5.
  • Kessaris DN, Bellman GC, Pardalidis NP, Smith AG. Management of hemorrhage after percutaneous renal surgery. J Urol 1995; 153: 604–8.
  • Martin X, Murat FJ, Feitosa LC, Rouviere O, Lyonnet D, Gelet A et al. Severe bleeding after nephrolithotomy: results of hyperselective embolization. Eur Urol 2000; 37: 136–9.
  • Patterson DE, Segura JW, LeRoy AJ, Benson RC Jr, May G. The etiology and treatment of delayed bleeding following percutaneous lithotripsy. J Urol 1985; 133: 447–51.
  • Reddy PK, Hulbert JC, Lange PH, Clayman RV, Marcuzzi A, Lapointe S et al. Percutaneous removal of renal and ureteral calculi: experience with 400 cases. J Urol 1985; 134: 662–5.
  • Sacha K, Szewczyk W, Bar K. Massive haemorrhage presenting as a complication after percutaneous nephrolithotomy (PCNL). Int Urol Nephrol 1996; 28: 315–8.
  • Srivastava A, Singh KJ, Suri A, Dubey D, Kumar A, Kapoor R et al. Vascular complications after percutaneous nephrolithotomy: are there any predictive factors? Urology 2005; 66: 38–40.
  • Stoller ML, Wolf JS Jr, St Lezin MA. Estimated blood loss and transfusion rates associated with percutaneous nephrolithotomy. J Urol 1994; 152: 1977–81.
  • Labate G, Modi P, Timoney A, Cormio L, Zhang X, Louie M et al. The percutaneous nephrolithotomy global study: classification of complications. J Endourol 2011; 25: 1275–80.
  • Yamaguchi A, Skolarikos A, Buchholz NP, Chomón GB, Grasso M, Saba P et al. Operating times and bleeding complications in percutaneous nephrolithotomy: a comparison of tract dilation methods in 5,537 patients in the Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study. J Endourol 2011; 25: 933–9.
  • İnci M, Şarlı B, Çelik A, Demirtaş A, Baydilli N, Akpek M et al. Relationship between urolithiasis and diastolic function of heart. Turk J Med Sci 2013; 43: 574-579.
  • Akman T, Binbay M, Akcay M, Tekinarslan E, Kezer C, Ozgor F et al. Variables that influence operative time during percutaneous nephrolithotomy: an analysis of 1897 cases. J Endourol 2011; 25: 1269–73.
  • El-Nahas AR, Shokeir AA, El-Assmy AM, Mohsen T, Shoma AM, Eraky I et al. Post-percutaneous nephrolithotomy extensive hemorrhage: a study of risk factors. J Urol 2007; 177: 576–
  • Muslumanoglu AY, Tefekli A, Karadag MA, Tok A, Sari E, Berberoglu Y. Impact of percutaneous access point number and location on complication and success rates in percutaneous nephrolithotomy. Urol Int 2006; 77: 340–6.
  • Tomaszewski JJ, Smaldone MC, Schuster T, Jackman SV, Averch TD. Factors affecting blood loss during percutaneous nephrolithotomy using balloon dilation in a large contemporary series. J Endourol 2010; 24: 207–11.
  • Cho CO, Yu JH, Sung LH, Chung JY, Noh CH. Comparison of percutaneous nephrolithotomy using pneumatic lithotripsy (lithoclast®) alone or in combination with ultrasonic lithotripsy. Korean J Urol 2010; 51: 783–7.
  • Lehman DS, Hruby GW, Phillips C, Venkatesh R, Best S, Monga M et al. Prospective randomized comparison of a combined ultrasonic and pneumatic lithotrite with a standard ultrasonic lithotrite for percutaneous nephrolithotomy. J Endourol 2008; 22: 285–9.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
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