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09:02
Percutaneous Hepatic Perfusion (PHP) with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver
Published on: July 31, 2016
Blood transfusion, embolisation and nephrectomy after percutaneous nephrolithotomy (PCNL).
Stephen R Keoghane1, Richard J Cetti, Ann E Rogers
1Department of Urology, Queen Alexandra Hospital, Portsmouth, UK. Stephen.Keoghane@porthosp.nhs.uk
BJU International
|September 11, 2012
Summary
Percutaneous nephrolithotomy (PCNL) carries risks, but this UK study shows low vascular complication rates. Higher transfusion risk is linked to older age, longer procedures, and urinary tract infections, supporting centralized stone surgery.
Area of Science:
- Urology
- Nephrology
- Surgical Outcomes
Background:
- Percutaneous nephrolithotomy (PCNL) is a key treatment for renal stones but has associated morbidity.
- Contemporary data on vascular complications and Intensive Care Unit (ICU) admissions after PCNL is crucial for patient consent and quality improvement.
Purpose of the Study:
- To audit the outcomes of PCNL over a decade at a UK centre.
- To provide contemporary data on blood loss and vascular risk for patients undergoing PCNL.
- To evaluate factors associated with transfusion and vascular complications.
Main Methods:
- Retrospective analysis of 568 PCNL procedures performed between April 2000 and December 2010.
- Statistical analysis of the association between transfusion and patient age, operative duration, and preoperative urinary tract infection (UTI).
- Review of vascular complications including angiography and embolisation.
Main Results:
- 3.8% of adult patients required blood transfusion, with increased risk in older patients, longer operative times, and positive preoperative urine samples.
- Seven patients (1.2%) required angiography, with five (0.9%) undergoing embolisation for vascular complications.
- No deaths occurred, but one patient (0.2%) needed an emergency nephrectomy due to bleeding complications.
Conclusions:
- This large UK series provides contemporary data on vascular risk associated with PCNL.
- Transfusion risk is associated with patient age, operative duration, and preoperative UTI.
- Outcomes compare favorably with international data, supporting the centralisation of specialist stone surgery.
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