Critical causes in severe bleeding requiring angioembolization after percutaneous nephrolithotomy

Bibliographic Details
Title: Critical causes in severe bleeding requiring angioembolization after percutaneous nephrolithotomy
Authors: Hee Youn Kim, Kyu Won Lee, Dong Sup Lee
Source: BMC Urology, Vol 20, Iss 1, Pp 1-7 (2020)
Publisher Information: BMC, 2020.
Publication Year: 2020
Collection: LCC:Diseases of the genitourinary system. Urology
Subject Terms: Kidney calculi, Percutaneous nephrolithotomy, Hemorrhage, Therapeutic embolization, Diseases of the genitourinary system. Urology, RC870-923
More Details: Abstract Background To identify the risk factors for severe bleeding requiring angioembolization among patients who received transfusions after PCNL, particularly those who underwent anatomically incorrect renal puncture. Methods A total of 53 patients, who received transfusions after PCNL and simultaneously had a postoperative CT scan performed between November 2009 and May 2019 at two teaching hospitals, were retrospectively reviewed. The patients were divided into two groups: those who underwent angioembolization and those who did not. Patient, stone and procedural factors were compared between the two groups. Puncture correctness was evaluated using postoperative CT scans. Puncture was defined as being a correct puncture if the fornix or papilla of the posterior calyx was punctured and the trajectory of the tract was within 20 degrees posterior to the frontal plane of the kidney (i.e., within Brödel’s line). Results 21 patients underwent angioembolization after PCNL. Incorrect puncture was seen in 14/21 (66.7%) patients who underwent angioembolization after PCNL, whereas it was seen in 11/32 (34.4%) patients who did not undergo angioembolization (p = 0.021). On multivariable regression analysis, puncture correctness was found to be the only significant factor, with an OR of 3.818, 95% CI of 1.192–12.231 and p value of 0.024. Conclusions Incorrect renal puncture was related to severe bleeding requiring angioembolization after PCNL. Our results emphasize the importance of the basic principle of renal puncture for PCNL.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1471-2490
Relation: http://link.springer.com/article/10.1186/s12894-020-00594-6; https://doaj.org/toc/1471-2490
DOI: 10.1186/s12894-020-00594-6
Access URL: https://doaj.org/article/71b5554e41034bb1aa870a12b38dd59d
Accession Number: edsdoj.71b5554e41034bb1aa870a12b38dd59d
Database: Directory of Open Access Journals
More Details
ISSN:14712490
DOI:10.1186/s12894-020-00594-6
Published in:BMC Urology
Language:English