2019, Number 3
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Rev Mex Urol 2019; 79 (3)
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: English
References: 19
Page: 1-14
PDF size: 195.98 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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