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

1.	龐家瑜, 陳春延, 堆偉棠, 等.經皮腎鏡碎石清石術治療巨大腎結石24例體會[J].廣西醫學, 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, 李遜, 吳開俊, 等.經皮腎穿刺取石術并發大出血的分析及對策[J].臨床泌尿外科雜志, 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.	李遜, 吳開俊.多通道經皮腎穿次取石治療復雜性腎結石[J].中華泌尿外科雜志, 1998, 19(8):426-427.
9.	馮鋼, 蘇澤軒, 李遜, 等.微創經皮腎鏡取石術的應用解剖及其臨床應用[J].中國臨床解剖學雜志, 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.	李遜, 孟祥軍, 曾國華, 等. CT三維重建在經皮腎鏡取石術中的應用價值[J].中華泌尿外科雜志, 2007, 28(6):379-381.
12.	張捷, 夏術階.微創經皮腎造瘺輸尿管鏡取石術的并發癥及處理[J].臨床泌尿外科雜志, 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.	朱結輝, 何乾文, 顧明, 等.經皮腎鏡取石碎石術術后大出血的介入治療[J].中國介入影像與治療學, 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. 龐家瑜, 陳春延, 堆偉棠, 等.經皮腎鏡碎石清石術治療巨大腎結石24例體會[J].廣西醫學, 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, 李遜, 吳開俊, 等.經皮腎穿刺取石術并發大出血的分析及對策[J].臨床泌尿外科雜志, 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. 李遜, 吳開俊.多通道經皮腎穿次取石治療復雜性腎結石[J].中華泌尿外科雜志, 1998, 19(8):426-427.
9. 馮鋼, 蘇澤軒, 李遜, 等.微創經皮腎鏡取石術的應用解剖及其臨床應用[J].中國臨床解剖學雜志, 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. 李遜, 孟祥軍, 曾國華, 等. CT三維重建在經皮腎鏡取石術中的應用價值[J].中華泌尿外科雜志, 2007, 28(6):379-381.
12. 張捷, 夏術階.微創經皮腎造瘺輸尿管鏡取石術的并發癥及處理[J].臨床泌尿外科雜志, 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. 朱結輝, 何乾文, 顧明, 等.經皮腎鏡取石碎石術術后大出血的介入治療[J].中國介入影像與治療學, 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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