Characteristics and Management of Massive Hemorrhage Secondary to Percutaneous Nephrolithotomy_West China Medical Journal

Authors：

 ZHANGBing-hong , WANGLiang , YANGWei , ZHOUTing-ting

Department of Urology, Chengdu General Hospital of Chengdu Military Command, Chengdu, Sichuan 610083, P. R. China;

Corresponding author：

Keywords：

Percutaneous nephrolithotomy; Hemorrhage; Embolization

DOI：

10.7507/1002-0179.20150011

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Objective To analyze the causes and characteristics of massive hemorrhage secondary to percutaneous nephrolithotomy (PCNL) and assess the value of superselective renal artery embolization in the management of this condition. Methods The imaging data and prognosis of 28 patients who developed repeated massive hemorrhage secondary to PCNL and underwent superselective renal artery embolization between April 2005 and June 2013 were reviewed. Results Following superselective renal artery embolization, hemorrhage was effectively controlled in all the 28 patients. Follow-up lasted from 6 to 62 months, averaging 41.6 months. No hematuria or other complications occurred during the follow-up period. Conclusion Superselective renal artery embolization is safe and effective in managing massive hemorrhage secondary to PCNL, and it may be used as a preferred treatment for patients who are refractory to expectant treatments.

Citation： ZHANGBing-hong, WANGLiang, YANGWei, ZHOUTing-ting. Characteristics and Management of Massive Hemorrhage Secondary to Percutaneous Nephrolithotomy. West China Medical Journal, 2015, 30(1): 42-48. doi: 10.7507/1002-0179.20150011 Copy

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4.	Stoller ML, Wolf J, Stlezin MA. Estimated blood loss and transfusion rates associated with percutenous nephrolithotomy[J]. J Urol, 1994, 152(6 Pt 1):1977-1981.
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6.	Zhang XC, Qiang QP. Complication and management of MPCNL[J]. Modern Pract Med, 2007, 19(4):262-270.
7.	Vignali C, Lonzi S, Bargellin I, et al. Vascular injuries after percutaneous renal procedures:treatment by transcatheter embolization[J]. Eur Radiol, 2004, 25(3):169-171.
8.	李逊, 吴开俊.多通道经皮肾穿次取石治疗复杂性肾结石[J].中华泌尿外科杂志, 1998, 19(8):426-427.
9.	冯钢, 苏泽轩, 李逊, 等.微创经皮肾镜取石术的应用解剖及其临床应用[J].中国临床解剖学杂志, 2004, 22(4):432-434.
10.	Thiruchelva MN, Mostafid H, Ubhayakar G. Planning percutaneous nephrolithotomy using multidetector computed tomography urography, multiplanar reconstruction an three-dimensional reformatting[J]. BJU Int, 2005, 95(9):1280-1284.
11.	李逊, 孟祥军, 曾国华, 等. CT三维重建在经皮肾镜取石术中的应用价值[J].中华泌尿外科杂志, 2007, 28(6):379-381.
12.	张捷, 夏术阶.微创经皮肾造瘘输尿管镜取石术的并发症及处理[J].临床泌尿外科杂志, 2007, 22(3):179-184.
13.	Tsu jmoto Y, Shima H, Mori Y, et al. Destruction of renal parenchyma at percutaneous nephrolithotripsy, experimental study[J]. Hinyokika Kivo, 1989, 35(7):1099-1103.
14.	Pappas P, Leonardou P, Papadoukak S, et al. Uregent superselective segmental renal artery embolization in the treatment of life threatening renal hemorrhage[J]. Urol Int, 2006, 77(1):34-41.
15.	朱结辉, 何乾文, 顾明, 等.经皮肾镜取石碎石术术后大出血的介入治疗[J].中国介入影像与治疗学, 2011, 8(1):18-21.
16.	Martine X, Murat FJ, Feitosa LC, et al. Severe blooding after nephrolihotomy, results of hyperselective embolization[J]. Eur Urol, 2000, 37(2):136-139.

1. 庞家瑜, 陈春延, 堆伟棠, 等.经皮肾镜碎石清石术治疗巨大肾结石24例体会[J].广西医学, 2007, 29(10):1596-1597.
2. Segura JW, Preminger GM, Assimos DG, et al. Nephrolithiasis clinical guidelines panel summary report on the management of staghorn calculi, the American urological association nephrolithiasis clinical guidelines panel[J]. J Urol, 1994, 151(6):1648-1651.
3. Kessaris DN, Bellman GC, Pardalidis NP, et al. Management of hemorrhage after percutaneous renal surgery[J]. J Urol, 1995, 153(3 Pt 1):604-608.
4. Stoller ML, Wolf J, Stlezin MA. Estimated blood loss and transfusion rates associated with percutenous nephrolithotomy[J]. J Urol, 1994, 152(6 Pt 1):1977-1981.
5. 王宇雄, 李逊, 吴开俊, 等.经皮肾穿刺取石术并发大出血的分析及对策[J].临床泌尿外科杂志, 2006, 21(2):96-97.
6. Zhang XC, Qiang QP. Complication and management of MPCNL[J]. Modern Pract Med, 2007, 19(4):262-270.
7. Vignali C, Lonzi S, Bargellin I, et al. Vascular injuries after percutaneous renal procedures:treatment by transcatheter embolization[J]. Eur Radiol, 2004, 25(3):169-171.
8. 李逊, 吴开俊.多通道经皮肾穿次取石治疗复杂性肾结石[J].中华泌尿外科杂志, 1998, 19(8):426-427.
9. 冯钢, 苏泽轩, 李逊, 等.微创经皮肾镜取石术的应用解剖及其临床应用[J].中国临床解剖学杂志, 2004, 22(4):432-434.
10. Thiruchelva MN, Mostafid H, Ubhayakar G. Planning percutaneous nephrolithotomy using multidetector computed tomography urography, multiplanar reconstruction an three-dimensional reformatting[J]. BJU Int, 2005, 95(9):1280-1284.
11. 李逊, 孟祥军, 曾国华, 等. CT三维重建在经皮肾镜取石术中的应用价值[J].中华泌尿外科杂志, 2007, 28(6):379-381.
12. 张捷, 夏术阶.微创经皮肾造瘘输尿管镜取石术的并发症及处理[J].临床泌尿外科杂志, 2007, 22(3):179-184.
13. Tsu jmoto Y, Shima H, Mori Y, et al. Destruction of renal parenchyma at percutaneous nephrolithotripsy, experimental study[J]. Hinyokika Kivo, 1989, 35(7):1099-1103.
14. Pappas P, Leonardou P, Papadoukak S, et al. Uregent superselective segmental renal artery embolization in the treatment of life threatening renal hemorrhage[J]. Urol Int, 2006, 77(1):34-41.
15. 朱结辉, 何乾文, 顾明, 等.经皮肾镜取石碎石术术后大出血的介入治疗[J].中国介入影像与治疗学, 2011, 8(1):18-21.
16. Martine X, Murat FJ, Feitosa LC, et al. Severe blooding after nephrolihotomy, results of hyperselective embolization[J]. Eur Urol, 2000, 37(2):136-139.

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West China Medical Journal

Characteristics and Management of Massive Hemorrhage Secondary to Percutaneous Nephrolithotomy

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