Influence of Technique of Percutaneous Tract Creation on Incidence of Renal Hemorrhage

Abstract

No AccessJournal of UrologyClinical Urology: Original Article1 Apr 1997Influence of Technique of Percutaneous Tract Creation on Incidence of Renal Hemorrhage Ramin Davidoff and Gary C. Bellman Ramin DavidoffRamin Davidoff and Gary C. BellmanGary C. Bellman View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)64931-0AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Renal hemorrhage is one of the most common and worrisome complications of percutaneous renal surgery. We studied the incidence of renal hemorrhage and transfusion rates in patients undergoing balloon or Amplatz fascial dilation of the nephrostomy tract. Materials and Methods: Medical records of 143 patients who underwent 150 percutaneous renal procedures, including percutaneous nephrolithotomy, antegrade endopyelotomy and percutaneous treatment of stones in caliceal diverticula, were reviewed. The nephrostomy tract was dilated with balloon (50 patients) or Amplatz sequential (100) dilators. Perioperative decreases in hemoglobin level and blood transfusion rates were compared between the 2 groups. Results: Of the 100 patients undergoing percutaneous renal Amplatz dilation 25 (25%) required a blood transfusion, compared to only 5 of 50 (10%) undergoing balloon dilation. The difference in the transfusion rates between the 2 groups was statistically significant (p = 0.048). Conclusions: Improvements in the technique of percutaneous renal surgery have decreased the morbidity associated with these procedures. In our study use of balloon tract dilators led to less renal hemorrhage and lower transfusion rates compared to Amplatz dilation. Additionally, balloon dilation appears to be more rapid and avoids renal movement away from the surgeon, which occasionally occurs during Amplatz dilation. References 1 : Endopyelotomy. Urol. Clin. N. Amer.1988; 15: 439. Google Scholar 2 : Outpatient endourologic procedures. Urol. Clin. N. Amer.1987; 14: 77. Google Scholar 3 : Review of accessories for percutaneous renal surgery. Brit. J. Urol.1984; 56: 577. Google Scholar 4 : Stents and catheters in percutaneous renal surgery. J. Endourol.1993; 7: 163. Google Scholar 5 : Dilation of the nephrostomy tract. Use of metal dilators. In: Controversies in Endourology. Edited by . Philadelphia: W. B. Saunders Co.1995: 42. chapt. 3. Google Scholar 6 : Estimated blood loss and transfusion rates associated with percutaneous nephrolithotomy. J. Urol.1994; 152: 1977. Link, Google Scholar 7 : Management of hemorrhage after percutaneous renal surgery. J. Urol.1995; 153: 604. Link, Google Scholar 8 : Percutaneous nephrolithotomy in the elderly. Urology1994; 44: 651. Google Scholar 9 : Complications of percutaneous nephrolithotomy. AJR1987; 148: 177. Google Scholar 10 : Percutaneous techniques. In: High Tech Urology: Technical Innovations and Their Clinical Applications. Edited by . Philadelphia: W. B. Saunders Co.1992: 208. chapt. 9. Google Scholar 11 : Percutaneous nephrolithotomy: one stage or two? Brit. J. Urol.1984; 56: 582. Google Scholar From the Department of Urology, Kaiser Permanente Medical Center, Los Angeles, California© 1997 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byOrdon M, Urbach D, Mamdani M, Saskin R, D'A Honey R and Pace K (2018) The Surgical Management of Kidney Stone Disease: A Population Based Time Series AnalysisJournal of Urology, VOL. 192, NO. 5, (1450-1456), Online publication date: 1-Nov-2014.Binbay M, Istanbulluoglu O, Sofikerim M, Beytur A, Skolarikos A, Akman T, Huri E, Ozturk B, Kural A and Muslumanoglu A (2018) Effect of Simple Malrotation on Percutaneous Nephrolithotomy: A Matched Pair Multicenter AnalysisJournal of Urology, VOL. 185, NO. 5, (1737-1741), Online publication date: 1-May-2011.Miller N, Matlaga B and Lingeman J (2018) Techniques for Fluoroscopic Percutaneous Renal AccessJournal of Urology, VOL. 178, NO. 1, (15-23), Online publication date: 1-Jul-2007.Baldwin D, Maynes L, Desai P, Jellison F, Tsai C and Barker G (2018) A Novel Single Step Percutaneous Access Sheath: The Initial Human ExperienceJournal of Urology, VOL. 175, NO. 1, (156-161), Online publication date: 1-Jan-2006.MUNVER R, DELVECCHIO F, NEWMAN G and PREMINGER G (2018) CRITICAL ANALYSIS OF SUPRACOSTAL ACCESS FOR PERCUTANEOUS RENAL SURGERYJournal of Urology, VOL. 166, NO. 4, (1242-1246), Online publication date: 1-Oct-2001.Bellman G, Davidoff R, Candela J, Gerspach J, Kurtz S and Stout L (2018) Tubeless Percutaneous Renal SurgeryJournal of Urology, VOL. 157, NO. 5, (1578-1582), Online publication date: 1-May-1997. Volume 157Issue 4April 1997Page: 1229-1231 Advertisement Copyright & Permissions© 1997 by American Urological Association, Inc.MetricsAuthor Information Ramin Davidoff More articles by this author Gary C. Bellman More articles by this author Expand All Advertisement PDF downloadLoading ...