Abstract
Objective This study investigated the risk factors for bleeding during minimally invasive percutaneous nephrolithotomy, so as to prevent the occurrence of bleeding and improve the surgical effect. Patients and Methods The data of 396 patients who underwent percutaneous nephrolithotomy by an experienced surgeon between May 2014 and December 2017 were retrospectively analyzed. To identify the risk factors for bleeding during percutaneous nephrolithotomy, each group was stratified according to the decrease in median hemoglobin. Age, gender, body mass index, stone size, operation time, stone type, degree of hydronephrosis, number of accesses, puncture guidance, underlying disease (diabetes; hypertension), and previous surgical history were evaluated. Univariate analysis was performed to calculate the potential factors. In order to determine the independence of each factor, we finally selected stone size, staghorn stone, degree of hydronephrosis, and operation time. Multivariate logistic regression analysis was used to identify the risk factors for bleeding during minimally invasive percutaneous nephrolithotomy. Results A total of 396 patients were successfully treated with percutaneous nephrolithotomy. The univariate analysis demonstrated that the potential risk factors for bleeding during percutaneous nephrolithotomy included stone size, type of stone, operative time, and degree of hydronephrosis. According to the previous studies, stone size, staghorn stone, degree of hydronephrosis, and operation time were ultimately selected. Multivariate logistic regression analysis was used to identify the risk factors for bleeding during percutaneous nephrolithotomy. According to the outcome of logistic regression analysis, stone size, staghorn stone, operation time, and degree of hydronephrosis were the risk factors for bleeding during minimally invasive percutaneous nephrolithotomy. Conclusions Percutaneous nephrolithotomy is an effective method for the treatment of upper urinary calculi with few complications. According to the results achieved by an experienced surgeon, the size of stone, staghorn stone, operation time, and degree of hydronephrosis were associated with the bleeding during minimally invasive percutaneous nephrolithotomy.
Highlights
Percutaneous nephrolithotomy for the treatment of renal and ureteral calculi is effective, minimally invasive, and repeatable
To identify factors influencing bleeding during minimally invasive percutaneous nephrolithotomy, the date of 396 patients were retrospectively analyzed in our study
All patients were successfully treated with minimally invasive percutaneous nephrolithotomy
Summary
Percutaneous nephrolithotomy for the treatment of renal and ureteral calculi is effective, minimally invasive, and repeatable. Michel et al reported that the success rate of percutaneous nephrolithotomy was more than 90%, but bleeding was still a common and serious complication, and the decrease in the hemoglobin level was 2.1-3.3 g/dl [1, 2]. It is important to identify the risk factors that may affect the incidence of bleeding and take active measures to reduce the occurrence of hemorrhage rather than take remedial measures after the occurrence of bleeding. Diabetes, staghorn calculi, and the number of access tracts may be risk factors for bleeding during minimally invasive percutaneous nephrolithotomy [4, 5]. To identify factors influencing bleeding during minimally invasive percutaneous nephrolithotomy, the date of 396 patients were retrospectively analyzed in our study.
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