Hemorrhage during and after percutaneous nephrolithotomy via standard nephrostomy tract / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the intra- and postoperative hemorrhage of percutaneous nephrolithotomy via the standard nephrostomy tract.</p><p><b>METHODS</b>A retrospective analysis was conducted among 1578 patients undergoing percutaneous nephrolithotomy. During the operations, all the nephrostomy tracts were dilated to F24 size after successful puncture. The stones were shattered and removed by EMS lithotrity system.</p><p><b>RESULTS</b>All the patients showed intra- and postoperative hemorrhage, and in 121 cases, blood transfusion was needed. In 18 patients, the operation had to be terminated for severe hemorrhage. The 8 patients with repeated bleeding were managed and cured by blood transfusion and medication. In another 2 cases, severe hemorrhage was found to result from false aneurysms by renal arteriography and managed by superselective embolization.</p><p><b>CONCLUSION</b>Percutaneous nephrolithotomy through standard nephrostomy tract is safe and does not increase the risk of bleeding with careful operation.</p>

Treatment of calculous pyonephrosis with percutaneous nephrolithotomy via the standard access / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the feasibility of treatment for calculous pyonephrosis with first stage percutaneous nephrolithotomy under the standard access.</p><p><b>METHODS</b>Thirty-six cases of calculous pyonephrosis and 36 cases of urolithiasis with no pyonephrosis were treated by percutaneous nephrolithotomy. In the nephrostomy, the caliber was dilated to F24. All the operations were preformed through the EMS lithotrity system. The intrapelvic pressure was detected in the operation. The hemoculture before and after operation, the germi culture of urine, and the temperature and blood leucocyte changes after operation were recorded. All the patients were treated by antibiotics before and after the operation.</p><p><b>RESULTS</b>All the patients were treated successfully. The average intrapelvic pressure were 23.2 cmH(2)O in non-pyonephrosis group and 22.8 cmH(2)O in pyonephrosis group. Both of the groups had 1 case of transient bacteremia after the operation. No significant difference was found in the other indices between the two groups.</p><p><b>CONCLUSION</b>EMS lithotrity system is safe and feasible for treating calculous pyonephrosis with stage I percutaneous nephrolithotomy via the standard access.</p>