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Risk Factors for Intra-operative Bleeding in Percutaneous Nephrolithotomy in an Academic Center: A Retrospective

Hamidreza Nasseh1, Gholamreza Mokhtari1, Samira Ghasemi2

  • 1Urology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Anesthesiology and Pain Medicine
|March 20, 2023
PubMed
Summary

Urinary tract infections and prior kidney surgeries increase bleeding risk during percutaneous nephrolithotomy (PNL). History of open surgery, nephrostomy, and ESWL are key risk factors for blood loss in PNL patients.

Keywords:
BleedingIntraoperative ComplicationsPercutaneous NephrolithotomyRisk Factors

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Area of Science:

  • Urology
  • Nephrology
  • Surgical Oncology

Background:

  • Percutaneous nephrolithotomy (PNL) is a preferred minimally invasive treatment for kidney stones.
  • Bleeding is a significant complication associated with PNL procedures.

Purpose of the Study:

  • To identify risk factors associated with bleeding during PNL.
  • To analyze patient and surgical characteristics that correlate with blood loss.

Main Methods:

  • Retrospective, descriptive, cross-sectional study design.
  • Data collected from 151 patients undergoing PNL for staghorn calculi in a prone position.
  • Analysis of demographics, surgical details, and outcomes, including hemoglobin drop.

Main Results:

  • No significant correlation found between stone burden, age, BMI, GFR, surgery duration, or number of tracts and hemoglobin drop.
  • Positive correlation identified between a history of Urinary Tract Infection (UTI) and hemoglobin drop (P=0.01).
  • History of open kidney surgery (P=0.031), nephrostomy insertion (P=0.003), and extracorporeal shock wave lithotripsy (ESWL) (P=0.041) were associated with increased bleeding risk.

Conclusions:

  • Urinary tract infection history is a significant risk factor for bleeding during PNL.
  • Previous open kidney surgery, nephrostomy placement, and ESWL treatment are associated with increased bleeding risk in PNL.
  • Identifying these risk factors can help improve patient management and outcomes in PNL.