EVALUATION OF THE CHARACTERISTICS OF KIDNEY STONES AND THEIR RELATIONSHIP WITH BLEEDING RATE IN PATIENTS UNDERGOING PERCUTANEOUS NEPHROLITHOTOMY

Farshid, S and Tayyebi, A and Sadri, M and Rezvankhah, V (2021) EVALUATION OF THE CHARACTERISTICS OF KIDNEY STONES AND THEIR RELATIONSHIP WITH BLEEDING RATE IN PATIENTS UNDERGOING PERCUTANEOUS NEPHROLITHOTOMY. Studies in Medical Sciences, 32 (1). pp. 40-46.

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Abstract

Percutaneous nephrolithotomy is a gold standard for renal stones with a diameter of more than 2 cm. One of the complications of percutaneous nephrolithotomy is intraoperative bleeding. This study was performed on the characteristics of kidney stones and their relationship with bleeding. Materials & Methods: In this descriptive study, 90 patients underwent percutaneous lithotomy. Inclusion criteria were age between 18 and 80 years, ASA class <III, and no coagulopathy. Exclusion criteria included the need for a Double J stent, patients with a history of Double J stents, the need for blood transfusions during surgery, and blood disorders. Hemoglobin level before surgery and 48 hours after surgery, and stone profile were recorded. The location of the stone and the size of the stone are extracted from the patient's radiological reports. After data collection, the data were entered into SPSS version 16. Results: In this study, the mean age of patients was 45.21±11.69 years (age range: 16 to 76 years). Regarding weight, the mean weight was 76.72±14.76 kg (weight range: 47 to 111 kg). The mean density was 647.55±285.41, the mean stone size was 26.20±21.06, the mean SSD was 81.24±27.96, the mean radiation reception time was 77.85±46.99, the mean KV was 92.50±15.20, and the mean mA was 37.37±1.18. The patients in this study had a mean history of 2.52 times ESWL with a mean of 1.81 stones. The mean access time was 31.20±15.66. The most commonplace of access was inferior calyces (74.4% of cases). The correlation between the differences in hemoglobin levels before and after surgery with the characteristics of the stone showed that the stone diameter demonstrated a significant relationship with the difference in hemoglobin levels. The time of surgery has a positive (r = 0.321) and significant correlation (p = 0.046) with hemoglobin difference before and after surgery. In Pearson correlation test, stone size (r = 0.131, p = 0.020), stone density (r = 0.101, p = 0.018), and access time to kidney (r = 0.329, p= 0.002) had a significant relationship with the duration of surgery. Conclusion: This study showed that only the diameter of the stone is correlated with the difference between hemoglobin levels before and after surgery. As the time of surgery increases, the difference in hemoglobin before and after surgery increases, leading to more bleeding. High stone density and stone size are effective factors in hemoglobin drop

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