PERCUTANEOUS ELECTROHEMOSTASIS AFTER PERCUTANEOUS NEPHROLITHOTOMY
https://doi.org/10.21886/2308-6424-2017-5-3-95-101
Abstract
The article describes the clinical case in a patient with bilateral nephrolithiasis, chronic kidney disease of the 4th stage, after which bleeding from the left kidney developed after simultaneous bilateral percutaneous nephrolithotomy (PNL), leading to severe hemic hypoxia. Conservative therapy, blood transfusion did not lead to a persistent effect, the bleeding continued to recur. Given the presence of chronic renal failure (CRF) from the embolization of the branches of the renal artery, it was decided to abstain, given the extremely high risk of aggravation of nephropathy after the administration of the contrast drug. Left-sided nephrectomy would inevitably lead to the development of terminal chronic renal failure. Patients performed an electrocoagulation of the fistula wall with a Karl Storz 26C resectoscope in 60W mode. The bleeding was completely stopped. The patient is discharged from the hospital in a satisfactory condition. At the time of discharge in the conduct of replacement renal therapy did not need. When analyzing publications in The Cochrane Library, PubMed, Medline and Web of Science, we did not find a description of such a method of hemostasis.
About the Authors
R. N. Trushkin
State hospital № 52, Moscow Department of Health.
Russian Federation
Russian Federation
Trushkin Ruslan Nikolaevich, PhD, head of department of urology. State hospital № 52, Moscow Department of Health.
Moscow.
P. T. Surkov
State hospital № 52, Moscow Department of Health.
Russian Federation
Russian Federation
Surkov Pavel Timofeyevich, urologist of department of urology. State hospital № 52, Moscow Department of Health.
Moscow.
A. E. Lubennikov
State hospital № 52, Moscow Department of Health.
Russian Federation
Russian Federation
Lubennikov Aleksandr Evgen’evich, PhD, urologist of department of urology. State hospital № 52, Moscow Department of Health.
Moscow.
N. V. Morozov
State hospital № 52, Moscow Department of Health.
Russian Federation
Russian Federation
Morozov Nikolay Vyacheslavovich, urologist of department of urology. State hospital № 52, Moscow Department of Health.
Moscow.
T. K. Isaev
State hospital № 52, Moscow Department of Health.
Russian Federation
Russian Federation
Isaev Tejmur Karibovich, PhD, urologist of department of urology. State hospital № 52, Moscow Department of Health.
Moscow.
References
1. Keoghane SR, Ce RJ, Rogers AE, Walmsley BH. Blood transfusion, embolisa on and nephrectomy a er percutaneous nephrolithotomy (PCNL). BJU Int. 2012;111(4):628-632/doi: 10.1111/j.1464410X.2012.11394.x
2. Un S, Cakir V, Kara C, Turk H, Kose O, Balli O, Yilmaz Y. Risk factors for hemorrhage requiring emboliza on a er percutaneous nephrolithotomy. Can Urol Assoc J. 2015;9(910):594-8. doi: 10.5489/cuaj.2803
3. Jones DJ, Russell GL, Kelle MJ, Wickham JE. The changing prac ce of percutaneous stone surgery. Review of 1000 cases 1981–1988. Br J Urol. 1990;66:1-5. doi: 10.1111/j.1464-410Х
4. Stoller M, Wolf JS Jr, St Lezin MA. Es mated blood loss and transfusion rates associated with percutaneous nephrolithotomy. J Urol 1994;152:1977-81. doi: 10.1016/ S0022-5347(17)32283-8
5. de la Rose e J, Assimos D, Desai M, Gu errez J, Lingeman J, Scarpa R, Tefekli A. The Clinical Research Offi ce of the Endourological Society Percutaneous Nephrolithotomy Global Study: indica ons, complica ons, and outcomes in 5803 pa ents. J Endourol. 2011;25:11-7. doi: 10.1089/end.2010.0424
6. Tayeb MM, Knoedler JJ, Krambeck AE, Paonessa JE, Mellon MJ, Lingeman JE. Vascular complica ons a er percutaneous nephrolithotomy: 10 years of experience. Urology. 2015;85(4):777-81. doi: 10.1016/j.urology.2014.12.044
7. Ierardi AM, Floridi C, Fontana F, Pinto A, Petrillo M, Kehagias E, Tse s D, Brunese L, Carrafi ello G. Transcatheter embolisa on of iatrogenic renal vascular injuries. Radiol Med. 2014;119:261-8. doi: 10.1007/s11547-013-0343-2
8. Chiang PH, Su HH. Randomized and prospec ve trial comparing tract crea on using plasma vaporiza on with balloon dilata on in percutaneous nephrolithotomy. BJU Int. 2013;112(1):89-93. doi: 10.1111/j.1464410X.2012.11507.x
9. Philip J. Comment on Randomized and prospec ve trial comparing tract crea on using plasma vaporiza on with balloon dilata on in percutaneous nephrolithotomy. BJU Int. 2013;112(1):3. doi: 10.1111/j.1464410X.2012.11520.x
10. Maheshwari PN, Sharma G, Shah NB. Comment on Randomized and prospec ve trial comparing tract crea on using plasma vaporiza on with balloon dilata on in percutaneous nephrolithotomy. BJU Int. 2013;112(7): 432. doi: 10.1111/bju.12408
Review
For citations:
Trushkin R.N., Surkov P.T., Lubennikov A.E., Morozov N.V., Isaev T.K. PERCUTANEOUS ELECTROHEMOSTASIS AFTER PERCUTANEOUS NEPHROLITHOTOMY. Urology Herald. 2017;5(3):95-101. (In Russ.) https://doi.org/10.21886/2308-6424-2017-5-3-95-101
Views:
1336
Email this article 
