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Organo Oficial de la Sociedad Mexicana de Urología

2019, Number 1

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Rev Mex Urol 2019; 79 (1)

Clinical factors related to bleeding in percutaneous nephrolithotomy

Calvo-Vázquez I, Rodríguez-Rodríguez B, Hernández-Méndez EA, Sánchez-Aquino UC, Martínez-Arroyo C, Fernández-Noyola G, Morales-Montor JG, Cantellano-Orozco M, Pacheco-Gahbler C

Language: Spanish
References: 19
Page: 1-10
PDF size: 171.51 Kb.


ABSTRACT

Objective: To determine the factors associated with the decrease in hemoglobin and hematocrit in percutaneous nephrolithotomy.
Materials and methods: Patients that underwent percutaneous nephrolithotomy within the time frame of January 2015 to January 2017 were included in the study. The factors associated with bleeding were analyzed using the Levene’s test, the Student’s t test, and inferential statistics.
Results: Sixty-nine patients underwent percutaneous nephrolithotomy. The mean decrease in hemoglobin and hematocrit after the procedure was 1.17 g/dl and 2.56%, respectively. The statistically significant factors were: diabetes mellitus (Hb, p ≤ 0.001/Hct, p = 0.017), high blood pressure (p = 0.007/p = 0.050), stone morphology (p = 0.004/p = 0.003), stone area (p = 0.003/p = 0.003), number of tracts (p = 0.002/p = 0.012), and surgery duration (p ≤ 0.001/p = 0.010). Positive culture (p = 0.030) and stone size (p=0.028) were significant only in relation to the decrease in hematocrit. A total of 27.5% patients had undergone previous surgery, mean stone size was 3.26 cm, the lower calyx was the most frequently punctured (78.3%), mean tract length was 8.41cm, and mean surgery duration cutoff time was 140 min. In our study, diabetes mellitus (RR = 1.8, CI = 1.4-2.3), high blood pressure (RR = 2.12, CI = 1.5-2.8), stone morphology (RR = 1.9, CI = 1.5-2.5), stone area (RR = 1.8, CI = 1.19-2.7), surgical technique and number of tracts (RR = 1.7, CI = 1.4-2.1), and surgery duration (RR = 1.9, CI = 1.3 -2.8) were the risk factors associated with decreased Hb and Hct values in percutaneous nephrolithotomy.
Conclusions: Percutaneous nephrolithotomy is a minimally invasive procedure for the treatment of kidney stones. In our study, the incidence of bleeding was low, and the transfusion rate was minimal, at 2.9%.


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