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Postoperative anatrophic nephrolithotomy bleeding.

D G Assimos, W H Boyce, L H Harrison

    The Journal of Urology
    |June 1, 1986
    PubMed
    Summary
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    Postoperative renal bleeding after anatrophic nephrolithotomy occurred in 6.4% of patients, often presenting days later. Management strategies were detailed, with low nephrectomy rates and no mortality.

    Area of Science:

    • Urology
    • Nephrology
    • Surgical Complications

    Background:

    • Anatrophic nephrolithotomy is a surgical procedure for large kidney stones.
    • Postoperative bleeding is a known complication, necessitating effective management strategies.

    Purpose of the Study:

    • To analyze the incidence, characteristics, and management of significant postoperative renal bleeding following anatrophic nephrolithotomy.
    • To describe a treatment plan for this specific complication.

    Main Methods:

    • Retrospective review of 530 patients undergoing anatrophic nephrolithotomy over a 14.5-year period.
    • Analysis of bleeding events, transfusion requirements, patient demographics, renal function, and interventions.

    Main Results:

    Related Experiment Videos

  • Significant postoperative renal bleeding occurred in 34 patients (6.4%), with an average transfusion need of 5,279 cc.
  • Bleeding patients were older with worse renal function; delayed bleeding (5-8 days) was common.
  • Bleeding dyscrasias identified in 6 patients; epsilon aminocaproic acid useful for slow bleeding; 8 patients required open renal exploration.

    • Conclusions:

    • Postoperative renal bleeding is a significant complication of anatrophic nephrolithotomy, associated with specific patient factors and delayed onset.
    • A structured treatment plan involving identification of bleeding dyscrasias, conservative measures, and surgical exploration is crucial.
    • Despite complications like arteriovenous fistulas, nephrectomy is rare, and mortality is avoided with appropriate management.