Percutaneous nephrolithotomy; alarming variables for postoperative bleeding

Objectives: To evaluate factors contributing to bleeding after percutaneous nephrolithotomy (PCNL) and ways of managing this complication, as bleeding is a serious sequela that requires prompt management. Patients and methods: The demographic and procedural data of 200 patients, who underwent unilat...

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Autores principales:	Shakhawan H.A. Said, Mohammed A. Al Kadum Hassan, Rawa H.G. Ali, Ismaeel Aghaways, Fahmi H. Kakamad, Khalid Q. Mohammad
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2017
Materias:	Percutaneous nephrolithotomy Bleeding Renal stones Complications Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/5f2657bff3ac44c2b1ed7fdad0f043da
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spelling	oai:doaj.org-article:5f2657bff3ac44c2b1ed7fdad0f043da2021-12-02T12:07:16ZPercutaneous nephrolithotomy; alarming variables for postoperative bleeding2090-598X10.1016/j.aju.2016.12.001https://doaj.org/article/5f2657bff3ac44c2b1ed7fdad0f043da2017-03-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2090598X16300985https://doaj.org/toc/2090-598XObjectives: To evaluate factors contributing to bleeding after percutaneous nephrolithotomy (PCNL) and ways of managing this complication, as bleeding is a serious sequela that requires prompt management. Patients and methods: The demographic and procedural data of 200 patients, who underwent unilateral PCNL during a 20-month period, were prospectively collected. Preoperative, operative, and postoperative details were recorded. The preoperative variables analysed included: age, sex, body mass index (BMI), the presence of hypertension, diabetes mellitus, serum creatinine, degree of hydronephrosis, previous ipsilateral open renal surgery, stone size and complexity. The operative variables analysed included: number of tracts, operative time, size of Amplatz sheath, type of anaesthesia, and complications such as calyceal and pelvic perforation. Results: The variables of age, sex, BMI, diabetes, hypertension, and a preoperative creatinine level of >1.4 mg/dL had no significant effect on blood loss (all P > 0.05). However, the rate of bleeding was significantly higher (P ⩽ 0.05) in patients who had a history of previous open renal surgery, intraoperative pelvicalyceal perforations, and Guy’s Stone Score (GSS) grade 3 and 4 complex stones; however, absence of hydronephrosis, larger stone size, operative time (>83 min), more than one puncture, and size of the Amplatz sheath (26–30 F) did not maintain their significance in multivariate analysis. Conclusion: According to our present results stone complexity (GSS grade 3 and 4), history of ipsilateral renal stone surgery, and occurrence of intraoperative pelvicalyceal perforation are alarming variables for post-PCNL bleeding.Shakhawan H.A. SaidMohammed A. Al Kadum HassanRawa H.G. AliIsmaeel AghawaysFahmi H. KakamadKhalid Q. MohammadTaylor & Francis GrouparticlePercutaneous nephrolithotomyBleedingRenal stonesComplicationsDiseases of the genitourinary system. UrologyRC870-923ENArab Journal of Urology, Vol 15, Iss 1, Pp 24-29 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Percutaneous nephrolithotomy Bleeding Renal stones Complications Diseases of the genitourinary system. Urology RC870-923
spellingShingle	Percutaneous nephrolithotomy Bleeding Renal stones Complications Diseases of the genitourinary system. Urology RC870-923 Shakhawan H.A. Said Mohammed A. Al Kadum Hassan Rawa H.G. Ali Ismaeel Aghaways Fahmi H. Kakamad Khalid Q. Mohammad Percutaneous nephrolithotomy; alarming variables for postoperative bleeding
description	Objectives: To evaluate factors contributing to bleeding after percutaneous nephrolithotomy (PCNL) and ways of managing this complication, as bleeding is a serious sequela that requires prompt management. Patients and methods: The demographic and procedural data of 200 patients, who underwent unilateral PCNL during a 20-month period, were prospectively collected. Preoperative, operative, and postoperative details were recorded. The preoperative variables analysed included: age, sex, body mass index (BMI), the presence of hypertension, diabetes mellitus, serum creatinine, degree of hydronephrosis, previous ipsilateral open renal surgery, stone size and complexity. The operative variables analysed included: number of tracts, operative time, size of Amplatz sheath, type of anaesthesia, and complications such as calyceal and pelvic perforation. Results: The variables of age, sex, BMI, diabetes, hypertension, and a preoperative creatinine level of >1.4 mg/dL had no significant effect on blood loss (all P > 0.05). However, the rate of bleeding was significantly higher (P ⩽ 0.05) in patients who had a history of previous open renal surgery, intraoperative pelvicalyceal perforations, and Guy’s Stone Score (GSS) grade 3 and 4 complex stones; however, absence of hydronephrosis, larger stone size, operative time (>83 min), more than one puncture, and size of the Amplatz sheath (26–30 F) did not maintain their significance in multivariate analysis. Conclusion: According to our present results stone complexity (GSS grade 3 and 4), history of ipsilateral renal stone surgery, and occurrence of intraoperative pelvicalyceal perforation are alarming variables for post-PCNL bleeding.
format	article
author	Shakhawan H.A. Said Mohammed A. Al Kadum Hassan Rawa H.G. Ali Ismaeel Aghaways Fahmi H. Kakamad Khalid Q. Mohammad
author_facet	Shakhawan H.A. Said Mohammed A. Al Kadum Hassan Rawa H.G. Ali Ismaeel Aghaways Fahmi H. Kakamad Khalid Q. Mohammad
author_sort	Shakhawan H.A. Said
title	Percutaneous nephrolithotomy; alarming variables for postoperative bleeding
title_short	Percutaneous nephrolithotomy; alarming variables for postoperative bleeding
title_full	Percutaneous nephrolithotomy; alarming variables for postoperative bleeding
title_fullStr	Percutaneous nephrolithotomy; alarming variables for postoperative bleeding
title_full_unstemmed	Percutaneous nephrolithotomy; alarming variables for postoperative bleeding
title_sort	percutaneous nephrolithotomy; alarming variables for postoperative bleeding
publisher	Taylor & Francis Group
publishDate	2017
url	https://doaj.org/article/5f2657bff3ac44c2b1ed7fdad0f043da
work_keys_str_mv	AT shakhawanhasaid percutaneousnephrolithotomyalarmingvariablesforpostoperativebleeding AT mohammedaalkadumhassan percutaneousnephrolithotomyalarmingvariablesforpostoperativebleeding AT rawahgali percutaneousnephrolithotomyalarmingvariablesforpostoperativebleeding AT ismaeelaghaways percutaneousnephrolithotomyalarmingvariablesforpostoperativebleeding AT fahmihkakamad percutaneousnephrolithotomyalarmingvariablesforpostoperativebleeding AT khalidqmohammad percutaneousnephrolithotomyalarmingvariablesforpostoperativebleeding
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Percutaneous nephrolithotomy; alarming variables for postoperative bleeding

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