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Predictive Factors for Bleeding During Percutaneous Nephrolithotomy

PURPOSE: Although percutaneous nephrolithotomy (PCNL) has been accepted as a standard method for the management of large renal stones, the incidence of renal hemorrhage is relatively high. This study investigated the variables that affect bleeding during PCNL. MATERIALS AND METHODS: The medical reco...

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Autores principales: Lee, Jeong Kuk, Kim, Bum Soo, Park, Yoon Kyu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Urological Association 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3715708/
https://www.ncbi.nlm.nih.gov/pubmed/23878687
http://dx.doi.org/10.4111/kju.2013.54.7.448
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author Lee, Jeong Kuk
Kim, Bum Soo
Park, Yoon Kyu
author_facet Lee, Jeong Kuk
Kim, Bum Soo
Park, Yoon Kyu
author_sort Lee, Jeong Kuk
collection PubMed
description PURPOSE: Although percutaneous nephrolithotomy (PCNL) has been accepted as a standard method for the management of large renal stones, the incidence of renal hemorrhage is relatively high. This study investigated the variables that affect bleeding during PCNL. MATERIALS AND METHODS: The medical records of 370 patients who underwent PCNL by a single surgeon from January 2005 to December 2010 were reviewed retrospectively. All patients were divided into two groups according to median blood loss (lesser bleeding group and higher bleeding group). Various clinical and perioperative factors including age, sex, stone size and position, degree of hydronephrosis, operative time, underlying disease, history of anticoagulant medication, presence of previous nephrostomy catheter, stone composition, and thickness of the renal cortex were assessed. For statistical assessment, univariate and multivariate logistic regression analyses were used. RESULTS: The mean patient age was 48.8 years (range, 22 to 75 years). Forty-three patients (11.6%) received a transfusion and 9 patients (2.4%) underwent angioembolization after surgery. The mean blood loss was 511.8±341.3 mL. Body mass index (BMI), stone size, stone position, operation time, and degree of preoperative hydronephrosis were predictive factors for severe bleeding during PCNL. CONCLUSIONS: On the basis of the results achieved by a single surgeon, staghorn stones, high BMI, large stones, prolonged operation time, and absence of hydronephrosis were significantly associated with the risk of severe bleeding during PCNL.
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spelling pubmed-37157082013-07-22 Predictive Factors for Bleeding During Percutaneous Nephrolithotomy Lee, Jeong Kuk Kim, Bum Soo Park, Yoon Kyu Korean J Urol Original Article PURPOSE: Although percutaneous nephrolithotomy (PCNL) has been accepted as a standard method for the management of large renal stones, the incidence of renal hemorrhage is relatively high. This study investigated the variables that affect bleeding during PCNL. MATERIALS AND METHODS: The medical records of 370 patients who underwent PCNL by a single surgeon from January 2005 to December 2010 were reviewed retrospectively. All patients were divided into two groups according to median blood loss (lesser bleeding group and higher bleeding group). Various clinical and perioperative factors including age, sex, stone size and position, degree of hydronephrosis, operative time, underlying disease, history of anticoagulant medication, presence of previous nephrostomy catheter, stone composition, and thickness of the renal cortex were assessed. For statistical assessment, univariate and multivariate logistic regression analyses were used. RESULTS: The mean patient age was 48.8 years (range, 22 to 75 years). Forty-three patients (11.6%) received a transfusion and 9 patients (2.4%) underwent angioembolization after surgery. The mean blood loss was 511.8±341.3 mL. Body mass index (BMI), stone size, stone position, operation time, and degree of preoperative hydronephrosis were predictive factors for severe bleeding during PCNL. CONCLUSIONS: On the basis of the results achieved by a single surgeon, staghorn stones, high BMI, large stones, prolonged operation time, and absence of hydronephrosis were significantly associated with the risk of severe bleeding during PCNL. The Korean Urological Association 2013-07 2013-07-15 /pmc/articles/PMC3715708/ /pubmed/23878687 http://dx.doi.org/10.4111/kju.2013.54.7.448 Text en © The Korean Urological Association, 2013 http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Lee, Jeong Kuk
Kim, Bum Soo
Park, Yoon Kyu
Predictive Factors for Bleeding During Percutaneous Nephrolithotomy
title Predictive Factors for Bleeding During Percutaneous Nephrolithotomy
title_full Predictive Factors for Bleeding During Percutaneous Nephrolithotomy
title_fullStr Predictive Factors for Bleeding During Percutaneous Nephrolithotomy
title_full_unstemmed Predictive Factors for Bleeding During Percutaneous Nephrolithotomy
title_short Predictive Factors for Bleeding During Percutaneous Nephrolithotomy
title_sort predictive factors for bleeding during percutaneous nephrolithotomy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3715708/
https://www.ncbi.nlm.nih.gov/pubmed/23878687
http://dx.doi.org/10.4111/kju.2013.54.7.448
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