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¿Es segura la nefrolitotomía percutánea en pacientes con trombocitosis? Un análisis retrospectivo de las series de
Bimalesh Purkait1, Himadri Pathak1, Kaushik Sarkar1
1Department of Urology, Vivekananda Institute of Medical Sciences, Kolkata, West Bengal, India.
Urology annals
|August 22, 2025
Resumen
La nefrolitomía percutánea (PCNL, por sus siglas en inglés) es eficaz para los cálculos renales. La trombocitosis leve a moderada en pacientes pediátricos y adultos jóvenes no aumentó el riesgo de hemorragia durante la NLP, pero se recomienda la consulta de hematología.
Área de la Ciencia:
- Urología
- Nefrología
- Hematología
Sus antecedentes:
- La nefrolitomía percutánea (PCNL) es el tratamiento estándar para los cálculos renales grandes.
- PCNL ofrece la tasa más alta libre de piedras (SFR) y se puede realizar con seguridad en pacientes pediátricos y ancianos.
- PCNL conlleva un riesgo de hemorragia, que puede aumentar en pacientes con problemas hematológicos como la trombocitosis.
Objetivo del estudio:
- Evaluar la seguridad y los resultados de la PCNL en pacientes pediátricos y adultos jóvenes con trombocitosis.
- Determinar si la trombocitosis leve a moderada aumenta el riesgo de hemorragia perioperatoria durante la NLP.
Principales métodos:
- Análisis retrospectivo de cuatro pacientes pediátricos y adultos jóvenes que se sometieron a PCNL entre 2017 y 2024.
- Se analizaron los resultados quirúrgicos, incluida la tasa libre de cálculos (SFR) y las complicaciones.
- Los pacientes presentaron trombocitosis.
Principales resultados:
- No se observaron complicaciones hemorrágicas perioperatorias importantes en los casos estudiados.
- La trombocitosis leve a moderada no pareció aumentar significativamente el riesgo de hemorragia durante la NLP.
- Todos los pacientes lograron la eliminación exitosa de la piedra.
Conclusiones:
- La NPC puede realizarse de forma segura en pacientes pediátricos y adultos jóvenes con trombocitosis de leve a moderada.
- Se recomienda una consulta hematológica y una estratificación del riesgo antes de la NLP en pacientes con trombocitosis.
- Para confirmar estos hallazgos, se requiere una investigación adicional con cohortes más grandes.
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