COMPLICATIONS OF PERCUTANEOUS NEPHROLITHOTRIPSY AND POSSIBLE WAYS OF THEIR CORRECTION
Abstract
Percutaneous nephrolithotripsy (PCNLT) is considered one of the main methods of treating urolithiasis with stones of more than 2 cm. The most dangerous complications are injuries to neighboring organs, bleeding, and exacerbation of chronic pyelonephritis.
The study included 463 patients with urolithiasis who underwent PCNLT. The analysis of complications and ways of their correction was carried out.
Exacerbation of calculous pyelonephritis occurred in patients with pre-existing retention of the cavitary system, as well as with existing bacteriuria.
The most formidable complication of PCNLT is bleeding from the cavitary system of the kidney. To stop the bleeding, in case of damage to the vessel along the nephrostomy access, superselective embolization of the branches of the renal artery can be successfully applied.
A considerable number of complications after PCNL are associated with infected large calculi. In such cases, it is preferable to perform preliminary drainage of the cavity system.
In cases of fornic bleeding, additional percutaneous drainage of the cavitary system minimizes blood loss due to adequate decompression of the cavitary system.
About the Authors
V. M. Popkov
ФГБОУ ВО «Саратовский государственный медицинский университет им. В.И. Разумовского» Минздрава России
Russian Federation
Russian Federation
D. N. Khotko
ФГБОУ ВО «Саратовский государственный медицинский университет им. В.И. Разумовского» Минздрава России
Russian Federation
Russian Federation
A. N. Ponukalin
ФГБОУ ВО «Саратовский государственный медицинский университет им. В.И. Разумовского» Минздрава России
Russian Federation
Russian Federation
A. I. Khotko
ФГБОУ ВО «Саратовский государственный медицинский университет им. В.И. Разумовского» Минздрава России
Russian Federation
Russian Federation
References
1. Knoll T, Daels F, Desai J, Hoznek A, Knudsen B, Montanari E, Scoffone C, Skolarikos A, Tozawa K. Percutaneous nephrolithotomy: technique. World J Urol. 2017 Sep;35(9):1361-1368. doi: 10.1007/s00345-017-2001-0. Epub 2017 Jan 25.
2. Vinaya P Bhatia, Tareq Aro, Shannon M Smith [et al.] Frailty as predictor of complications in patients undergoing percutaneous nephrolithotomy (PCNL). World J Urol. 2021 Oct;39(10):3971-3977. doi: 10.1007/s00345-021-03681-x. Epub 2021 Apr 2.
3. Arora A.M., Pawar P.W., Tamhankar A.S., Sawant A.S., Mundhe S.T., Patil S.R. Predictors for severe hemorrhage requiring angioembolization post percutaneous nephrolithotomy: A single-center experience over 3 years. Urol Ann. 2019;11:180–186.
4. de Oliveira JMI, Selegatto IB, Simoes GCS, Ottaiano AD, Neto WA, Reis LO. Analysis of surgical complications of percutaneous nephrolythotomy, in the first three years, in a teaching hospital. Am J Clin Exp Urol. 2021 Dec 15;9(6):497-503. eCollection 2021.
5. de la Rosette JJ, Opondo D, Daels FP, Giusti G, Serrano A, Kandasami SV, Wolf JS Jr, Grabe M, Gravas S; CROES PCNL Study Group. Categorisation of complications and validation of the Clavien score for percutaneous nephrolithotomy. Eur Urol. 2012 Aug;62(2):246-55. doi: 10.1016/j.eururo.2012.03.055.
6. Sujeet Poudyal. Current insights on haemorrhagic complications in percutaneous nephrolithotomy. Asian J Urol. 2022 Jan;9(1):81-93. doi: 10.1016/j.ajur.2021.05.007. Epub 2021 May 29.
7. Keoghane SR, Cetti RJ, Rogers AE [et al.] Blood transfusion, embolisation and nephrectomy after percutaneous nephrolithotomy (PCNL). BJU Int 2013;111:628–632.
8. S.V. Shkodkin, Yu.B. Idashkin, V.N. Dmitriev, A.V. Lyubushkin, A.A. Nevskij. Hemorrhagic complications of percutaneous surgery for nephrolithiasis. Urologiia. 2017; 5:80-85. (in Russ.); DOI: https://dx.doi.org/10.18565/urology.2017.5.80-85
9. Gonen M, Turan H, Ozturk B [et al] (2008) Factors affecting fever following percutaneous nephrolithotomy: a prospective clinical study. J Endourol 22:2135.
10. Patel N, Shi W, Liss M, Raheem O, Wenzler D, Schallhorn C, Kiyama L, Lakin C, Ritter M, Sur RL. Multidrug resistant bacteriuria before percutaneous nephrolithotomy predicts for postoperative infectious complications. J Endourol. 2015 May;29(5):531-6. doi: 10.1089/end.2014.0776. Epub 2014 Dec 29.
11. Rivera M, Viers B, Cockerill P, Agarwal D, Mehta R, Krambeck AJ. Preand postoperative predictors of infection-related complications in patients undergoing percutaneous nephrolithotomy. Endourol 2016;30(9):982-6. doi: 10.1089/end.2016.0191.
12. Nouralizadeh A., Ziaee S.A., Hosseini Sharifi S.H., Basiri A., Tabibi A., Sharifiaghdas F., [et al.] Delayed postpercutaneous nephrolithotomy hemorrhage: Prevalence, predictive factors and management. Scand J Urol. 2014;48:110–115. doi: 10.3109/21681805.2013.806586.
13. Richstone L., Reggio E., Ost M.C., Seideman C., Fossett L.K., Okeke Z., [et al.] Hemorrhage following percutaneous renal surgery: Characterization of angiographic findings. J Endourol. 2008;22:1129–1136. doi: 10.1089/end.2008.0061.
14. Mao Q., Wang C., Chen G., Tan F.S.B. Failure of initial superselective renal arterial embolization in the treatment of renal hemorrhage after percutaneous nephrolithotomy: A retrospective analysis of risk factors. Exp Ther Med. 2019;18:4151–4156. doi: 10.3892/etm.2019.8033.
15. Thapa N, Baral S, Chhetri RK, Paudel S. Predictive Factors for Post-Operative Bleeding in Percutaneous Nephrolithotomy. Journal of Lumbini Medical College. 2019;7(2):5 pages. DOI: doi.org/10.22502/jlmc.v7i2.283
Review
For citations:
Popkov V.M., Khotko D.N., Ponukalin A.N., Khotko A.I. COMPLICATIONS OF PERCUTANEOUS NEPHROLITHOTRIPSY AND POSSIBLE WAYS OF THEIR CORRECTION. Bashkortostan Medical Journal. 2023;18(1):32-36. (In Russ.)
Views:
197
Email this article 
