Aron Monish, Goel Rajiv, Kesarwani Pawan K, Gupta Narmada P
Department of Urology, All India Institute of Medical Sciences, New Delhi, India.
Urol Int. 2004;73(3):244-7. doi: 10.1159/000080835.
Tubeless PNL (percutaneous nephrolithotomy), in a highly selected group of patients, is a modification aimed at reducing the morbidity of PNL. We present a simple technique of achieving tract hemostasis as an adjunct to the safe performance of a tubeless PNL.
Charts of 40 consecutive patients who underwent tubeless PNL at our center were reviewed. In the latter 20 consecutive patients, diathermy coagulation of the intrarenal bleeders and tract was done and these patients were compared with the earlier 20 patients in whom fulguration was not done. Drop in hemoglobin, postoperative analgesic requirement, operating time, length of hospitalization and postoperative complications were compared.
No statistical difference was found between the operative times and drop in hemoglobin for both the groups. The length of hospitalization and postoperative analgesic requirement were significantly less in the fulguration group. No significant complications were noted in either of the two groups.
Fulguration of visible intrarenal and tract bleeders is a simple, safe and effective hemostatic adjunct in patients undergoing tubeless PNL.
对于经过严格筛选的特定患者群体，无管经皮肾镜取石术（PNL）是一种旨在降低经皮肾镜取石术发病率的改良术式。我们介绍一种实现通道止血的简单技术，作为无管经皮肾镜取石术安全操作的辅助手段。
回顾了在我们中心连续接受无管经皮肾镜取石术的40例患者的病历。在连续的后20例患者中，对肾内出血点和通道进行了透热凝固，并将这些患者与前20例未进行电灼的患者进行比较。比较了血红蛋白下降情况、术后镇痛需求、手术时间、住院时间和术后并发症。
两组的手术时间和血红蛋白下降情况均无统计学差异。电灼组的住院时间和术后镇痛需求明显更少。两组均未发现明显并发症。
对可见的肾内和通道出血点进行电灼，对于接受无管经皮肾镜取石术的患者来说，是一种简单、安全且有效的止血辅助方法。
