Related Experiment Video
Updated: Jul 28, 2025
5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats
Published on: April 4, 2025
Application of Bipolar Cauterization During Standard Percutaneous Nephrolithotomy
Je Mo Yoo1, Hee Youn Kim1, Dong Sup Lee1
1Department of Urology, St. Vincent's Hospital, The Catholic University of Korea, Suwon, South Korea.
Insights
Bipolar cauterization effectively manages tract site bleeding after percutaneous nephrolithotomy (PCNL). This method reduces the need for transfusions compared to nephrostomy placement, improving patient outcomes.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Nephrology
Background:
- Tract site bleeding is a complication during percutaneous nephrolithotomy (PCNL).
- Effective management strategies are crucial to minimize blood loss and transfusion requirements.
Purpose of the Study:
- To evaluate the efficacy of bipolar cauterization for managing tract site bleeding post-PCNL.
- To compare outcomes between bipolar cauterization, nephrostomy placement, and no intervention for bleeding control.
Main Methods:
- A study involving 181 patients undergoing standard PCNL.
- Patients were categorized into three groups: no procedure, nephrostomy placement, or bipolar cauterization for tract site bleeding.
- Postoperative hemoglobin levels and transfusion rates were compared across groups.
Main Results:
- The bipolar cauterization group showed significantly less median hemoglobin decrease (-0.2) compared to the nephrostomy group (-1.75) and no procedure group (-1.0) (P < .001).
- Transfusion rates were markedly lower in the cauterization group (3.2%) versus the nephrostomy group (41.7%) (P < .001).
Conclusions:
- Bipolar cauterization is an effective method for controlling tract site bleeding after PCNL.
- This technique significantly reduces the need for blood transfusions, offering a favorable alternative to nephrostomy placement.
Abstract:
We aimed to evaluate the efficacy of bipolar cauterization for tract site bleeding during standard percutaneous nephrolithotomy (PCNL). We defined tract site bleeding as when the visual field across the parenchymal tract starts to bleed while the sheath of a balloon dilator is being withdrawn just before the operation is completed. Among 181 patients, 90 patients showed no significant bleeding, and 91 patients required further procedures to resolve tract site bleeding. In cases of unresolved tract site bleeding, either nephrostomy placement (n = 60) or cauterization (n = 31) was performed. The outcomes of three groups (no procedure group, nephrostomy group and cauterization group) were compared. The median decrease in hemoglobin at 2-hour intervals postoperatively was -1.75, -1.0, and -0.2 in the nephrostomy, cauterization, and no procedure groups, respectively (P < .001). There were 25 patients (41.7%) who received transfusions in the nephrostomy group, whereas only 1 patient (3.2%) received a transfusion in the cauterization group (P < .001). The bipolar cauterization of bleeding points at the end of PCNL could efficiently decrease tract site bleeding and reduce the need for transfusion. Clinical Research Information Service (https://cris.nih.go.kr/cris; No. KCT0008303).
Related Concept Videos
01:25Urinary Tract Calculi VI: Surgical Management
01:28Cardiac Catheterization I: Pre-Procedure Overview