MP68-09 CONTINUING ASPIRIN DOES NOT INCREASE BLOOD LOSS FROM PERCUTANEOUS NEPHROLITHOTOMY

2017 ◽  
Vol 197 (4S) ◽  
Author(s):  
Timothy Tran ◽  
Egor Parkhomenko ◽  
Julie Thai ◽  
Kyle Blum ◽  
Mantu Gupta
Keyword(s):  
Blood Loss ◽  
Percutaneous Nephrolithotomy ◽  
Increase Blood Loss

The Role of Tranexamic Acid in Controlling Bloodloss During PCNL for Staghorn Calculi

2019 ◽  
Vol 69 (12) ◽  
pp. 3745-3748
Author(s):  
Raluca Costina Barbilian ◽  
Victor Cauni ◽  
Bogdan Mihai ◽  
Ioana Buraga ◽  
Mihai Dragutescu ◽  
...  
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Percutaneous Nephrolithotomy ◽  
Kidney Stones ◽  
Postoperative Bleeding ◽  
Invasive Technique ◽  
Transfusion Rate ◽  
Staghorn Calculi ◽  
Type Of Surgery

The aim of this paper is to assess the efficiency and safety of the tranexamic acid in reducing blood loss and the need for transfusion in patients diagnosed with staghorn calculi treated by percutaneous nephrolithotomy. Percutaneous nephrolithotomy (PCNL) is a minimally invasive technique used for large kidney stones. Hemorrhagic complications and urinary sepsis are serious complications associated with this type of surgery. Tranexamic acid is an antifibrinolytic drug that has the property of reducing intra or postoperative bleeding. The experience with tranexamic acid in preventing blood loss during percutaneous nephrolithotomy for is limited. The use tranexamic acid in percutaneous nephrolithotomy for staghorn type stones is safe and is associated with reduced blood loss and a lower transfusion rate.

scholarly journals Efficacy and safety of laparoscopic pyelolithotomy versus percutaneous nephrolithotomy for treatment of large renal stones: a meta-analysis

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098313
Author(s):  
Tie Mao ◽  
Na Wei ◽  
Jing Yu ◽  
Yinghui Lu
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Percutaneous Nephrolithotomy ◽  
Meta Analysis ◽  
Renal Stones ◽  
Efficacy And Safety ◽  
Complementary Treatment ◽  
Laparoscopic Pyelolithotomy ◽  
Stone Free Rate ◽  
Free Rate

Background We aimed to compare the efficacy and safety of laparoscopic pyelolithotomy (LPL) versus percutaneous nephrolithotomy (PCNL) for treating renal stones larger than 2 cm. Methods We searched the PubMed, Embase, Web of Science, SinoMed, and Chinese National Knowledge Infrastructure databases for studies that compared the surgical outcomes of LPL and PCNL. We conducted a meta-analysis of the retrieved studies, expressed as weighted mean difference or risk ratios with 95% confidence intervals. Results We included 25 studies (1831 patients). LPL was associated with a significantly higher stone-free rate, lower rates of blood loss, complementary treatment, blood transfusion, and complications, and less reduction in hemoglobin level compared with PCNL. LPL and PCNL were similar in terms of duration of hospital stay, conversion rate, changes in glomerular filtration rate and creatinine level, and mean time of postoperative analgesia. However, LPL was associated with a longer operation time than PCNL. Conclusion LPL appears to be more effective and safer than PCNL in patients with large renal stones, by increasing the stone-free rate and reducing blood loss, complementary treatment, blood transfusion, and complications compared with PCNL. LPL may thus be a useful modality for treating patients with large renal stones.

scholarly journals Blood loss predictive factors and transfusion practice during percutaneous nephrolithotomy of kidney stones: a prospective study

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 1550 ◽  
Author(s):  
Firtantyo Adi Syahputra ◽  
Ponco Birowo ◽  
Nur Rasyid ◽  
Faisal Abdi Matondang ◽  
Endrika Noviandrini ◽  
...  
Keyword(s):  
Blood Loss ◽  
Prospective Study ◽  
Percutaneous Nephrolithotomy ◽  
Predictive Factors ◽  
Transfusion Practice ◽  
Influential Factor ◽  
Full Blood Count ◽  
Baseline Serum ◽  
Stone Burden ◽  
A Prospective Study

Objectives Bleeding is the most common complication of percutaneous nephrolithotomy (PCNL). Injudicious transfusion is frequently performed in current practice, even though it is not always needed. This study aimed to identify the predictive factors of blood loss in the PCNL procedure and evaluate the perioperative transfusion practice. Methods A prospective study of PCNL was randomly performed by two consultants of endo-urology at our institution. The inclusion criteria were adults with kidney pelvic stones >20 mm or stone in inferior calyx >10 mm or staghorn stone. Those with coagulopathy, under anti-coagulant treatment or open conversion were excluded. A full blood count was taken at baseline and during 12, 24, 36, 72-hours post-operatively. Factors such as stone burden, sex, body surface area, shifting of hematocrit level and amount of blood transfused were analyzed statistically using line regression to identify the predictive factors of total blood loss (TBL).   Results Eighty-five patients were enrolled in this study. Mean TBL was 560.92 ± 428.43 mL for both endo-urology surgeons. Stone burden was the most influential factor for TBL (p=0.037). Our results revealed that TBL (mL) = -153.379 + 0.229 × stone burden (mm2) + 0.203 x baseline serum hematocrit (%); thus considerably predicted the need for blood transfusion. A total of 87.1% patients did not receive perioperative transfusion, 3.5% received intra-operative transfusion, 7.1% received post-operative transfusion, 23% had both intra and post-operative transfusion, resulting in a cross-matched transfusion ratio of 7.72. Mean perioperative blood transfused was 356.00 ± 145.88 mL.

Does Intraoperative Hetastarch Administration Increase Blood Loss and Transfusion Requirements After Cardiac Surgery?

2000 ◽  
Vol 9 (4) ◽  
pp. 801-807 ◽  
Author(s):  
Jill E. Knutson ◽  
Jane A. Deering ◽  
Frank W. Hall ◽  
Gregory A. Nuttall ◽  
Darrell R. Schroeder ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Blood Loss ◽  
Transfusion Requirements ◽  
Increase Blood Loss

scholarly journals Comparison of General versus Spinal Anesthesia in Patients undergoing Percutaneous Nephrolithotomy: A Prospective Randomized Study

2016 ◽  
Vol 5 (1) ◽  
pp. 37-42
Author(s):  
Rupak Bhattarai ◽  
Chittarranjan Das ◽  
Bandana Paudel ◽  
Sailoj Jung Dangi
Keyword(s):  
Patient Satisfaction ◽  
Blood Loss ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Percutaneous Nephrolithotomy ◽  
P Value ◽  
Recovery Duration ◽  
Significant Difference ◽  
Hospital Stays ◽  
Surgical Duration

Background Percutaneous Nephrolithotomy, widely used procedure by urologists for removing renal stones nowadays. Generally, it is preferred in general anesthesia but here in our study we have compared it with spinal anesthesia to know its safety and efficacy.Material and Methods Sixty patients of either sex, aged between 20-60 years, ASA – Grade I and II, with stones size larger than 15 mm posted for Percutaneous Nephrolithotomy were randomly selected. Patient was divided in two groups 30 each, Spinal Anesthesia (S) and General Anesthesia (G). Patient’s stones sizes, numbers & location, Anesthesia duration, Surgical duration, Recovery duration, Blood loss and Blood transfusion, Analgesic demand, post-operative Nausea & Vomiting, Patient satisfaction, Hospital stays and Heart Rate and Mean arterial pressure between two groups were compared.Results There was no significant difference in terms of mean age, weight, stones sizes, and numbers and its location. The p value for Anesthesia duration and surgical duration were 0.144 and 0.22 which was insignificant. Recovery duration (p-value 0.007), Blood loss (p-value 0.004) were significantly lesser in spinal anesthesia group. There was no significant difference in nausea and vomiting, patient satisfaction when compared between two groups. But Analgesic demand, Blood Transfusion and Hospital stays significantly found to be decreased in spinal anesthesia groups (p<0.05). The mean of MAP showed no significant difference except in 10 and 20 minutes.Conclusion Spinal anesthesia tends to be as effective as general anesthesia for PCNL and beneficial in terms of recovery duration, blood loss, analgesic demands, hospital stays, hence decrease the cost of patient. Journal of Nobel Medical CollegeVolume 5, Number 1, Issue 8, January-July 2016, Page: 37-42

scholarly journals Which factors affect the success of pediatric PCNL? Single center experience over 20 years

2020 ◽  
Vol 92 (4) ◽  
Author(s):  
Volkan Izol ◽  
Nihat Satar ◽  
Yıldırım Bayazit ◽  
Fatih Gokalp ◽  
Nebil Akdogan ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Pediatric Patients ◽  
Operation Time ◽  
Fluoroscopy Time ◽  
Postoperative Blood Transfusion ◽  
Group 2 ◽  
Group 1

Objective: We aimed to investigate the impact of surgeons’ experience on pediatric percutaneous nephrolithotomy (PCNL) outcomes. Materials and methods: Between June 1997 and June 2018, 573 pediatric patients with 654 renal units underwent PCNL for renal stone disease by senior surgeons. Data were divided into two groups, group-1 (n = 267), first ten years period, group-2 (n = 387); second ten years period. Results: Mean ± SD age of patients was 7.6 ± 4.9 (1-17) years. The stone-free rates (SFR) assessed after 4 weeks were 74.9% vs. 83.4% in group-1 vs. group-2, respectively (p = 0.03). The mean operation time, fluoroscopy time, and the number of patients requiring blood transfusion significantly decreased in group 2 (100.4 ± 57.5 vs. 63.63 ± 36.3, 12.1 ± 8.3 vs. 8.3 ± 5.4, and 24.3% vs. 2.9%; p < 0.001, p < 0.001, and p = 0.002 in group-1 versus group-2, respectively). On multivariate analysis, increasing stone size increased operation time (p < 0.001), fluoroscopy time (p < 0.001), intraoperative and postoperative blood transfusion rates (p = 0.006 and p = 0.018, respectively), and hospital stay (p = 0.002) but was not associated with change of glomerular filtration rate (GFR) (p = 0.71). Sheath size also correlated with increased fluoroscopy time (p < 0.001), operation time (p < 0.001), intraoperative blood transfusion (p < 0.001) and hospital stay, but sheath size did not affect postoperative blood transfusion (p = 0.614) or GFR change (p = 0.994). Conclusions: The percutaneous nephrolithotomy (PCNL) is a minimally invasive procedure and is well accepted because of its lower complication rate and high efficiency for pediatric patients. Stone and sheath size are predictive factors for blood loss and hospital stay. During 20 years, our fluoroscopy time, operation time, blood loss, and complication rates decreased, and stone-free rate increased.

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