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Inicio Actas Urológicas Españolas (English Edition) Treatment of hemorrhagic complications of percutaneous nephrolithotomy in Galdak...
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Vol. 37. Issue 9.
Pages 587-591 (October 2013)
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Vol. 37. Issue 9.
Pages 587-591 (October 2013)
Casuistry
Treatment of hemorrhagic complications of percutaneous nephrolithotomy in Galdakao position
Tratamiento de las complicaciones hemorrágicas de la nefrolitotomía percutánea en posición de Galdakao
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I. Nuño de la Rosaa, J.L. Palmeroa,
Corresponding author
jlpalmero@hospital-ribera.com

Corresponding author.
, J. Mirallesa, A. Amorósa, M.D. Ferrerb, E. Estebanb
a Unidad de Litotricia y Endourología, Servicio de Urología, Hospital Universitario La Ribera, Alzira, Valencia, Spain
b Unidad de Radiología Intervencionista, Hospital Universitario La Ribera, Alzira, Valencia, Spain
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Table 1. General characteristics of patients with bleeding complications after percutaneous nephrolithotomy in Galdakao position.
Table 2. General characteristics and treatment of patients with arterial lesions after percutaneous nephrolithotomy in Galdakao position.
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Abstract
Objective

Percutaneous Nephrolithotomy (PCNL) is a technique with good results for the treatment of kidney stones, however, bleeding complications derived can be serious if not diagnosed and treated effectively. The aim of this study is to assess bleeding complications resulting from PCNL in Galdakao position and therapeutic management.

Materials and methods

Retrospective-longitudinal study of 172 PCNL performed in La Ribera Hospital between January 2005 and December 2011, analyzing their bleeding complications and the treatment provided for resolution.

Results

20 patients (11.6%) had bleeding complications. The need for transfusion in this series was 8.1% and the most common cause of blood transfusion was the presence of postoperative retroperitoneal (7.5%). There were 6 arterial injuries (3.5%), 5 of them successfully treated with angiography and arterial selective embolization.

Conclusions

The arterial injuries following PCNL are rare but can be serious. The possibility of an urgent arteriography and selective embolization to the diagnosis permits an effective and safe treatment of bleeding without risk to the affected renal unit.

Keywords:
Renal arteriography
Selective embolization
Hemorrhage
Resumen
Objetivo

La nefrolitotomía percutánea (NLPC) es una técnica con buenos resultados para el tratamiento de la litiasis renal, sin embargo, las complicaciones hemorrágicas derivadas de la misma puedes ser graves si no son diagnosticadas y tratadas eficazmente. El objetivo de este estudio es evaluar las complicaciones hemorrágicas derivadas de la nefrolitotomía percutánea en posición de Galdakao y su manejo terapéutico.

Material y métodos

Estudio longitudinal retrospectivo de 172 NLPC realizadas en el Hospital La Ribera entre enero de 2005 y diciembre de 2011, analizando sus complicaciones hemorrágicas y el tratamiento establecido para su resolución.

Resultados

Presentaron complicaciones hemorrágicas 20 pacientes (11.6%). El requerimiento transfusional de esta serie fue de 8.1% y la causa más frecuente de transfusión el hematoma perirrenal post-operatorio (7.5%). Hubo 6 lesiones arteriales (3.5%), 5 de ellas tratadas satisfactoriamente con arteriografía y embolización selectiva de la lesión.

Conclusiones

Las lesiones arteriales por NLPC son poco frecuentes pero pueden ser graves. La posibilidad de realizar de manera urgente arteriografía y embolización selectiva, ante el diagnóstico de una lesión vascular tras NLPC, permite el tratamiento de la hemorragia de una manera eficaz y segura sin riesgo para la unidad renal afectada.

Palabras clave:
Arteriografía renal
Embolización selectiva
Hemorragia

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