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Related Concept Videos

Cardiac Catheterization I: Pre-Procedure Overview01:28

Cardiac Catheterization I: Pre-Procedure Overview

Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
Cardiac Catheterization IV: Nursing Management01:26

Cardiac Catheterization IV: Nursing Management

Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
Urinary Tract Calculi III: Medical Management01:30

Urinary Tract Calculi III: Medical Management

The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...

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A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy
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Published on: September 13, 2022

Predictive factors for bleeding during percutaneous nephrolithotomy.

Jeong Kuk Lee1, Bum Soo Kim, Yoon Kyu Park

  • 1Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea.

Korean Journal of Urology
|July 24, 2013
PubMed
Summary

Percutaneous nephrolithotomy (PCNL) for large kidney stones can cause significant bleeding. Factors like staghorn stones, high BMI, and prolonged operation time increase this risk.

Keywords:
HemorrhageKidney calculiPercutaneous nephrolithotomy

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Area of Science:

  • Urology
  • Nephrology
  • Surgical Oncology

Background:

  • Percutaneous nephrolithotomy (PCNL) is a primary treatment for large renal calculi.
  • Renal hemorrhage is a known complication of PCNL.

Purpose of the Study:

  • To identify clinical and perioperative factors associated with bleeding during PCNL.
  • To investigate predictors of severe hemorrhage in PCNL patients.

Main Methods:

  • Retrospective review of 370 PCNL cases performed by a single surgeon.
  • Analysis of patient demographics, stone characteristics, and operative variables.
  • Univariate and multivariate logistic regression for statistical analysis.

Main Results:

  • Mean blood loss was 511.8±341.3 mL; 11.6% required transfusion, 2.4% angioembolization.
  • Predictive factors for severe bleeding included body mass index (BMI), stone size and position, operation time, and preoperative hydronephrosis.
  • Staghorn stones, high BMI, large stones, prolonged operation time, and absence of hydronephrosis were significantly associated with bleeding risk.

Conclusions:

  • High BMI, large or staghorn stones, prolonged operative time, and lack of hydronephrosis are key risk factors for PCNL-related bleeding.
  • These findings can aid in patient selection and surgical planning to mitigate hemorrhage risk.
  • Further research may refine risk stratification for PCNL procedures.