TAIPEI, TAIWAN (UroToday.com) - In their report of a 10-year experience of vascular complications with PCNL, Dr. El Tayeb and Dr. Lingeman’s group show an extremely low rate of vascular complications requiring angiography of 0.48%. The reported rate in the literature is up to 2%.
“Our techniques are different from the usual radiologist-gained access in that we are exact, triangulate the needle into the proper calyx, and avoid the infundibulum. We are careful not to torque the needle as it enters the kidney, and liberally use flexible nephroscopes,” says El Tayeb.
This is among the largest retrospective studies in the literature, looking at 3 338 PCNLs between 2003-2013. The study finds no possible predictors of vascular complications with PCNL, as indicated by abrupt, brisk, or intermittent bleeding. There was no difference between patients who bled and those who did not with regard to age, history of UTI, location of the access (lower pole, upper pole, etc), previous urologic procedures, operative time, and cases requiring multiple access.
“Vascular complications are a rare and random event in our institution,” concludes El Tayeb.
Presented by Marawan M. El Tayeb,1 John J. Knoedler,2 Amy E. Krambeck,2 Jessica E. Paonessa,1 Matthew J. Mellon,1 and James E. Lingeman1 at the 32nd World Congress of Endourology & SWL - September 3 - 7, 2014 - Taipei, Taiwan
1Indiana University School of Medicine, Indianapolis, IN USA 2
Mayo Clinic, Rochester, MN USA
Written by Adam Kaplan,MD, chief resident, Department of Urology, School of Medicine, University of California-Irvine, and medical writer for UroToday.com