Managementul complicaţiilor hemoragice post nefrolitotomie percutanatǎ prin abord endovascular

Braticevici, B.; Ambert, V.; Salaheddin, Y.; Diaconescu, D.; Popescu, M.; Petca, R.; Bengus, F.; Hainagiu, L.; Jinga, V.; Dorobăţ, B.; Nechifor, R.; Tomescu, L.
September 2010
Romanian Journal of Urology;Sep2010, Vol. 9 Issue 3, p43
Academic Journal
Introduction. The purpose of this study is to prove the efficacy of the endovascular renal approach with selective and over selective embolisation in the control of the severe post PCNL hemorrhages. Method and material. This is a retrospective study which took place between 01.07.2007 and 01.08.2010 in the "Prof Th Burghele" hospital, on a number of 1132 patients with pelvicaliceal lithiasis. A number of 148 hemorrhagic complications were observed. Only 10 of the patients presenting hemorrhagic complications had severe post PCNL hemorrhage. Results. The renal angiography with selective embolisation represents the most adequate treatment for the renovascular complications. Its success rate is of over 80%, and only minimum complications appeared.[6] In our study, the success rate was 87.5%. Conclusions. The incidence of post PCNL severe hemorrhagic complications (grade III a Clavien) is low, its average being of 0.8%, which indicates PCNL as a safe and efficient surgical technique. The elective therapeutically indication in post PCNL vascular renal lesions is the selective arterial renal embolisation. By shortening the period between the complication diagnostic and the endovascular treatment the number of hospitalization days could be reduced, as well as the costs. More than that, it would allow a more rapid social integration of the patient with post PCNL vascular complication.


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