Cause and management of delayed hemorrhage after minimally invasive percutaneous nephrolithotomy
10.3760/cma.j.issn.1000-6702.2010.12.011
- VernacularTitle:微创经皮肾镜取石术后迟发大出血的原因及防治策略
- Author:
Muchun ZHANG
;
Jihong ZHU
;
Qiyan PIAO
;
Gang ZHANG
;
Yonggang WANG
;
Ji GAO
;
Yun ZHANG
;
Lin LIU
;
Jiwen WANG
- Publication Type:Journal Article
- Keywords:
Percutaneous nephrolithotomy;
Postoperative hemorrhage;
Universal precaution
- From:
Chinese Journal of Urology
2010;31(12):822-824
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the cause and management of delayed hemorrhage after minimally invasive percutaneous nephrolithotomy (PCNL). Methods From 2004 to 2009,there were 13 cases (10 men and 3 women, mean age 47 years) developed severe bleeding following PCNL. The cause of hemorrhage and treatments were retrospectively analyzed and summarized. Results The time of hemorrhage was 5-40 d. In 7 of 13 cases, the bleeding were was controlled by complete bed rest,hemostatic,balloon compression and clamped nephrostomy tube. Six of 13 underwent selective renal arteriography after ineffective with conservative treatment. The DSA showed 4 were false aneurysm and 2 were arteriovenous fistula. All the 6 cases were treated by the super-selective arteriolar embolization. The hematuria was disappeared 1- 3 d later. The intravenous pyelogram revealed the renal function kept well during follow-up visit. Conclusions Delayed hemorrhage is one of the severe complications, which may be caused when the renal puncture passage established as forming false aneurysm and arteriovenous fistula. The renal arteriography and super-selective arteriolar embolization could be a safe and effective treatment for the severe hemorrhage after PCNL.
