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Post-Percutaneous Nephrolithotomy Extensive Hemorrhage: A Study of Risk Factors

2007; Lippincott Williams & Wilkins; Volume: 177; Issue: 2 Linguagem: Inglês

10.1016/j.juro.2006.09.048

1527-3792

Ahmed R. El‐Nahas, Ahmed A. Shokeir, Ahmed El‐Assmy, Tarek Mohsen, Ahmed M. Shoma, Ibrahim Eraky, Mahmoud R. El‐Kenawy, Hamdy A. El‐Kappany,

Pediatric Urology and Nephrology Studies

No AccessJournal of UrologyAdult urology1 Feb 2007Post-Percutaneous Nephrolithotomy Extensive Hemorrhage: A Study of Risk Factors Ahmed R. El-Nahas, Ahmed A. Shokeir, Ahmed M. El-Assmy, Tarek Mohsen, Ahmed M. Shoma, Ibrahim Eraky, Mahmoud R. El-Kenawy, and Hamdy A. El-Kappany Ahmed R. El-NahasAhmed R. El-Nahas More articles by this author , Ahmed A. ShokeirAhmed A. Shokeir More articles by this author , Ahmed M. El-AssmyAhmed M. El-Assmy More articles by this author , Tarek MohsenTarek Mohsen More articles by this author , Ahmed M. ShomaAhmed M. Shoma More articles by this author , Ibrahim ErakyIbrahim Eraky More articles by this author , Mahmoud R. El-KenawyMahmoud R. El-Kenawy More articles by this author , and Hamdy A. El-KappanyHamdy A. El-Kappany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2006.09.048AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We identified risk factors predicting severe bleeding due to percutaneous nephrolithotomy. Materials and Methods: Computerized data on 2,909 patients who underwent a total of 3,878 percutaneous nephrolithotomy procedures between January 1995 and December 2005 were retrospectively reviewed. Data on patients who experienced severe bleeding requiring angiographic renal embolization were compared with those on other patients using univariate and multivariate analyses. We tested the characteristics of patients, kidneys and stones together with details of the operative procedure and surgeon experience. Results: Severe bleeding complicated a total of 39 procedures (1%) in 25 males and 14 females with a mean age of 50.7 ± 12.6 years. Associated morbidity included shock in 6 patients and perirenal hematoma in 4. Renal angiography revealed pseudoaneurysm in 20 patients, arteriovenous fistula in 9, the 2 lesions in 8 and arterial laceration in 2. Bleeding could be controlled with superselective embolization in 36 patients (92.3%). Followup was available on 33 patients (mean 21 ± 15 months). Renal function was stable in all patients except 3 who had a post-embolization increase in serum creatinine, of whom all had a solitary kidney and none required renal replacement therapy. Significant risk factors for severe bleeding were upper caliceal puncture, solitary kidney, staghorn stone, multiple punctures and inexperienced surgeon. Conclusions: Percutaneous nephrolithotomy should be performed by an experienced endourologist in patients at risk for severe bleeding, such as those with a solitary kidney or staghorn stones. 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Link, Google Scholar Urology and Radiology Departments, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt© 2007 by American Urological AssociationFiguresReferencesRelatedDetailsCited byOlvera-Posada D, Tailly T, Alenezi H, Violette P, Nott L, Denstedt J and Razvi H (2015) Risk Factors for Postoperative Complications of Percutaneous Nephrolithotomy at a Tertiary Referral CenterJournal of Urology, VOL. 194, NO. 6, (1646-1651), Online publication date: 1-Dec-2015.Önal B, Dogan H, Satar N, Bilen C, Güneş A, Özden E, Ozturk A, Demirci D, İstanbulluoğlu O, Gurocak S, Nazli O, Tanriverdi O, Kefi A, Korgali E, Silay M, Inci K, İzol V, Altintas R, Kilicarslan H, Sarikaya S, Yalcin V, Aygun C, Gevher F, Aridogan I and Tekgul S (2013) Factors Affecting Complication Rates of Percutaneous Nephrolithotomy in Children: Results of a Multi-Institutional Retrospective Analysis by the Turkish Pediatric Urology SocietyJournal of Urology, VOL. 191, NO. 3, (777-782), Online publication date: 1-Mar-2014.Assimos D (2013) Re: Therapy-Resistant Nephrolithiasis Following Renal Artery Coil EmbolizationJournal of Urology, VOL. 190, NO. 6, (2125-2125), Online publication date: 1-Dec-2013.Zeng G, Zhao Z, Wan S, Khadgi S, Long Y, Zhang Y, Cao G and Yang X (2013) Failure of Initial Renal Arterial Embolization for Severe Post-Percutaneous Nephrolithotomy Hemorrhage: A Multicenter Study of Risk FactorsJournal of Urology, VOL. 190, NO. 6, (2133-2138), Online publication date: 1-Dec-2013.Kumar S, Randhawa M, Ganesamoni R and Singh S (2012) Tranexamic Acid Reduces Blood Loss During Percutaneous Nephrolithotomy: A Prospective Randomized Controlled StudyJournal of Urology, VOL. 189, NO. 5, (1757-1761), Online publication date: 1-May-2013.Akman T, Binbay M, Kezer C, Yuruk E, Tekinarslan E, Ozgor F, Sari E, Aslan R, Berberoglu Y and Muslumanoglu A (2012) Factors Affecting Kidney Function and Stone Recurrence Rate After Percutaneous Nephrolithotomy for Staghorn Calculi: Outcomes of a Long-Term FollowupJournal of Urology, VOL. 187, NO. 5, (1656-1661), Online publication date: 1-May-2012.Xue W, Pacik D, Boellaard W, Breda A, Botoca M, Rassweiler J, Van Cleynenbreugel B and de la Rosette J (2012) Management of Single Large Nonstaghorn Renal Stones in the CROES PCNL Global StudyJournal of Urology, VOL. 187, NO. 4, (1293-1297), Online publication date: 1-Apr-2012.Dugi D, Morey A, Gupta A, Nuss G, Sheu G and Pruitt J (2009) American Association for the Surgery of Trauma Grade 4 Renal Injury Substratification Into Grades 4a (Low Risk) and 4b (High Risk)Journal of Urology, VOL. 183, NO. 2, (592-597), Online publication date: 1-Feb-2010.Neto E, Mitre A, Gomes C, Arap M and Srougi M (2007) Percutaneous Nephrolithotripsy With the Patient in a Modified Supine PositionJournal of Urology, VOL. 178, NO. 1, (165-168), Online publication date: 1-Jul-2007. Volume 177Issue 2February 2007Page: 576-579 Advertisement Copyright & Permissions© 2007 by American Urological AssociationKeywordshemorrhagekidney calculipercutaneousembolizationtherapeutickidneynephrolithotomyMetricsAuthor Information Ahmed R. El-Nahas More articles by this author Ahmed A. Shokeir More articles by this author Ahmed M. El-Assmy More articles by this author Tarek Mohsen More articles by this author Ahmed M. Shoma More articles by this author Ibrahim Eraky More articles by this author Mahmoud R. El-Kenawy More articles by this author Hamdy A. El-Kappany More articles by this author Expand All Advertisement PDF downloadLoading ...