Management of severe haemorrhage following minimally invasive percutaneous nephrolithotomy / 中国医师杂志

ABSTRACT

Objective To investigate the management of severe haemorrhage following minimally invasive percutaneous nephrolithotomy.Methods A retrospective study was accomplished on 3857 patients of minimally invasive percutaneous nephrolithotomy from Jan 1995 to Feb 2004.Fourteen patients,11 males and 3 females with a mean age of 45 years,developed severe haemorrhage requiring a haemostasis procedure(0.4%).Results Three cases of nephrectomies for haemostasis were performed at the beginning of our experience.Renal arteriography was performed in 11 patients,and the results showed that 5 patients were suffered with arteriovenous fistulas,4 cases with false aneurysms,1 case with arteriovenous fistulas and false aneurysms,and 1 case with arteriolar injury.All the patients with vascular abnormalities were successfully treated by highly selective embolization.Conclusion The severe haemorrhage following minimally invasive percutaneous nephrolithotomy is a rare complication,but impossible to be predicted.Renal arteriography and selective embolization is a safe and effective procedure for the management of severe haemorrage following minimally invasive percutaneous nephrolithotomy.