Analysis of perioperative hemorrhage in percutanous nephrolithotomy via standard nephrostomy tract

We retrospectively reviewed the clinical data of 7 patients with intraoperative or postoperative hemorrhage, who underwent percutanous nephrolithotomy (PCNL) in Beijing Luhe Hospital between 2010 and 2016.There are 5 males and 2 females with a mean age 50.7 year (30-75 years). There were 4 cases of multiple stones in kidney, 2 cases of mold stones and 1 case of stone in upper ureter.Digital subtraction angiography (DSA) showed 5 cases of false aneurysms after operation: on lower pole arterial branches in 3 cases and on middle pole arterial branches in 2 cases.Two patients with hemorrhage during operation underwent immediate digital subtraction angiography with negative result and the bleeding disappeared 1 week later with conservative therapy.False aneurysms and arteriovenous fistula caused by the procedure may lead to hemorrhage during and after PCNL.Hyperselective renal arteriolar embolization is an effective and safe method to treat delayed hemorrhage after PCNL. Key words: Lithotripsy; Nephrostomy, percutaneous; Postoperative hemorrhage; Hyperselective renal arteriolar embolization