Saman Farshid1, Masumeh Seyed Karimi2, Mohamad sadri3 and Mahdi Hemmati Ghavshough4*

Bleeding during percutaneous nephrolithotomy (PCNL) surgery is a significant concern and a common surgical complication. This study aimed to identify factors associated with excessive bleeding in patients during or after PCNL surgery.

In this retrospective study, a total of 357 patients who underwent PCNL surgery were evaluated within the period from October 2019 to October 2020. Patient-related factors, kidney stones, and surgical details were recorded. The median drop in hemoglobin after PCNL was 5.1, and values exceeding this were considered as excessive bleeding.

In this study, only 51.2% of patients experienced decreased hemoglobin levels. The average stone size in patients with and without reduced hemoglobin levels was 2.48 cm and 2.41 cm, respectively. The mean duration of surgery in patients with and without a decrease in hemoglobin levels was 58.69 minutes and 55.30 minutes, respectively. The mean access time for patients with and without reduced hemoglobin levels was 68.62 seconds and 65.71 seconds, respectively. The mean exposure time to radiation for patients with and without a decrease in hemoglobin levels was 74.11 seconds and 68.80 seconds, respectively. In this study, no significant relationship was found between patient gender, stone size, duration of surgery, access time, previous surgical history, and a decrease in hemoglobin levels. However, a significant association was observed between the access site and decreased hemoglobin levels.

Despite concerns regarding intraoperative complications, PCNL is an effective and safe treatment modality for patients with kidney stones, irrespective of their clinical treatment history. Furthermore, the advantages of this minimally invasive approach can be applied to all patients.

Keywords : bleeding, kidney stones, percutaneous nephrolithotomy, hemorrhage, risk factors

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