Massive hemorrhage after percutaneous nephrolithotomy: Saving the kidney when angioembolization has failed or is unavailable

Aminsharifi, Alireza; Irani, Dariush; Eslahi, Ali

doi:10.1016/j.ijsu.2014.07.004

Cited by 14 publications

(21 citation statements)

References 15 publications

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“…PCNL is thought to be less invasive and might have lower complication rate than open pyelolithotomy. Nevertheless, it is found that PCNL is still associated with greater kidney functional damage and higher risk for life threatening hemorrhage [ 24 , 25 ]. On the basis of a hospital-based analysis of pyelolithotomy, the average duration for hospital stay is 3.9 days [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Postoperative Renal Outcomes of Patients Receiving Percutaneous Nephrolithotomy versus Pyelolithotomy: A Population-Based Cohort Study

Chen

Liu

Cheng

et al. 2018

BioMed Research International

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The aim of this population-based cohort study was to explore postoperative renal outcomes of patients receiving pyelolithotomy versus percutaneous nephrolithotomy (PCNL). Data were retrieved from the Taiwan National Health Insurance Research Database. During the period from Jan 1, 1998, to Dec 31, 2012, there were 2549 and 21654 patients who underwent pyelolithotomy and PCNL, respectively. The postoperative incidence of new diagnosed end stage renal disease (ESRD) was statistically analyzed and compared between the pyelolithotomy and PCNL groups. The perioperative complications of two groups were also analyzed. In comparison to pyelolithotomy, PCNL achieved lower new diagnosed ESRD (1.38% versus 2.28%, p = 0.0004). Patients receiving PCNL had significantly higher rates of preoperative hypertension, diabetes mellitus, pulmonary disease, cerebrovascular disease, and coronary artery disease. The hospital stay was shorter in PCNL groups compared with pyelolithotomy groups (8.31 days versus 12.59 days, p = 0.0006). In conclusion, PCNL contributed to lower rates of new diagnosed ESRD and hospital stay when compared to pyelolithotomy.

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Section: Discussionmentioning

confidence: 99%

Postoperative Renal Outcomes of Patients Receiving Percutaneous Nephrolithotomy versus Pyelolithotomy: A Population-Based Cohort Study

Chen

Liu

Cheng

et al. 2018

BioMed Research International

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“…There are few publications in the literature about renorraphy in massive bleedings following PNL. Aminsharifi et al (6) have performed open surgical exploration in 8 patients who could not undergo angioembolization for various reasons, and they have performed partial nephrectomy in 2 and renorraphy in 6 of them (6). They could maintain hemostasis in patients who underwent renorraphy and they discharged the patients without experiencing any severe postoperative problems.…”

Section: Discussionmentioning

confidence: 99%

“…Conservative methods are generally sufficient to stop bleeding in many patients although renal angioembolization is required in less than 1% of patients (5). Renorraphy and nephrectomy are alternative options in patients who cannot undergo angioembolization (6).…”

Section: Introductionmentioning

confidence: 99%

Management of Massive Hemorrhage after Percutaneous Nephrolithotomy: Angioembolization or Renorrhaphy

Tuncer¹,

Faydaci²,

Eryıldırım³

et al. 2015

jus

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It is known that renal angiography and embolization is an effective and safe method in massive bleeding after percutaneous nephrolithotomy. In our study, we found that renal angiography is superior to renorraphy. What's known on the subject? and What does the study add? ABSTRACT ÖZ ObjectiveWe present two treatment modalities, selective renal angioembolization and renorraphy, in massive renal hemorrage after percutaneous nephrolithotomy (PCNL) that could not be controlled by conservative methods. Materials and MethodsOne thousand two-hundred patients, who had undergone PCNL between January 2003 and February 2014, were retrospectively reviewed. From these cases, we selected patients with massive post procedural bleeding that could not be taken under control by conservative methods and we reviewed their clinical course and treatment results. ResultsBleeding could not controlled by conservative methods in 6 patients and, angioembolization was done succesfully. In 3 patients, angioembolization was not available. Renorraphy was performed in 2 patients and nephrectomy in 1 patient at first attempt. Renorraphy could not solve the problem of massive hemorrage and these 2 patients eventually underwent nephrectomy. ConclusionRenal angiography and embolization is an effective and safe method and renorraphy should not be the first option in massive bleeding after PCNL that can not be taken under control by conservative methods.

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“…Bleeding complications are usually treated conservatively, with a transfusion rate of 5.7% . Up to 1% of the patients required renal angiography with embolization Repeat embolization up to three times, partial nephrectomy or renorrhaphy are options for failed embolization . Urinary leakage, renal pelvis perforation and urinary fistula might require double‐J ureteric catheterization, and hydrothorax might require chest drain insertion.…”

Section: Pcnlmentioning

confidence: 99%

“…[90][91][92] Repeat embolization up to three times, partial nephrectomy or renorrhaphy are options for failed embolization. 93,94 Urinary leakage, renal pelvis perforation and urinary fistula might require double-J ureteric catheterization, and hydrothorax might require chest drain insertion.…”

Section: Complicationsmentioning

confidence: 99%

Updates in endourological management of urolithiasis

Teoh

2018

Int J of Urology

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Urinary stone disease, or urolithiasis, is a very common disease with increasing prevalence and incidence. With the advancement of endoscopic techniques, the treatment outcomes of ureteroscopy (or transureteral lithotripsy) and percutaneous nephrolithotomy are continuously improving. In recent years, there have been many new developments in the field, including new endoscopy design, more effective auxiliary tools, improvement in treatment protocols, introduction of robotic technology, combining both ureteroscopy and percutaneous nephrolithotomy (endoscopic combined intrarenal surgery or transureteral lithotripsy‐assisted percutaneous nephrolithotomy), improvement in laser technology, and so on. All these new inputs will further improve the treatment efficacy and safety of the procedures, thus benefiting our patients. In the present review, we briefly go through the main steps of ureteroscopy and percutaneous nephrolithotomy, with a concise description and application of these new advances.

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Massive hemorrhage after percutaneous nephrolithotomy: Saving the kidney when angioembolization has failed or is unavailable

Abstract: Massive hemorrhage after PCNL when angioembolization failed or was not feasible due to any reason could be controlled by partial nephrectomy or renorrhaphy with the same principles as that used for surgical exploration in patients with high grade renal trauma.

Cited by 14 publications

References 15 publications

Postoperative Renal Outcomes of Patients Receiving Percutaneous Nephrolithotomy versus Pyelolithotomy: A Population-Based Cohort Study

Postoperative Renal Outcomes of Patients Receiving Percutaneous Nephrolithotomy versus Pyelolithotomy: A Population-Based Cohort Study

Management of Massive Hemorrhage after Percutaneous Nephrolithotomy: Angioembolization or Renorrhaphy

Updates in endourological management of urolithiasis

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