title: Previous open renal surgery increased vascular complications in percutaneous nephrolithotomy (PCNL) compared with primary and secondary PCNL and extracorporeal shock wave lithotripsy patients: a retrospective study.
abstract: OBJECTIVE
  To evaluate the vascular complications of percutaneous nephrolithotomy (PCNL) patients who have undergone previous open surgery, PCNL and extracorporeal shock wave lithotripsy (ESWL).
  
  
  METHODS
  360 patients who underwent a PCNL procedure were included into the study. The patients were divided into 4 groups: group 1: primary PCNL (n = 232); group 2: previous open nephrolithotomy (n = 42); group 3: previous PCNL (n = 33); group 4: previous ESWL (n = 63). The periods of operation and fluoroscopy use of the groups were compared in terms of residual stones, with haematuria, pre-operation and post-operation first-day haemoglobin values. Patients with persistent haematuria were assessed through ultrasonography (US), Doppler US, computed tomography and angiography.
  
  
  RESULTS
  Upon comparison of the patients' pre- and post-operative haemoglobin changes, haemoglobin was statistically higher in the previous open operation group than the others (p = 0.02). Permanent and intermittent haematuria were detected in 12 (3%) and 7 patients (1%), respectively. Angiography was done in 7 (1.94%) patients. This rate was 9.5% for group 2 and 3% for group 3. These rates were found to be statistically higher than compared to the other groups. Arteriovenous fistula (AVF) was detected in 4 of these patients and pseudoaneurysm in 1. While 1 of the patients with AVF improved spontaneously, embolisation was applied to 4 patients. Four of the patients had had a previous open operation, while 1 had had a PCNL treatment.
  
  
  CONCLUSIONS
  Vascular complication is a rare complication of PCNL that can be successfully managed with angioembolisation. Our results indicate that previous open surgery significantly predicted the occurrence of these lesions.
authors.affiliation: Department of Urology, Gazi University School of Medicine, Ankara, Turkey.
authors.forename: Suleyman
authors.initials: S
authors.lastname: Yesil
authors.forename: Ufuk
authors.initials: U
authors.lastname: Ozturk
authors.forename: Hasan Nedim Goksel
authors.initials: HN
authors.lastname: Goktug
authors.forename: Can
authors.initials: C
authors.lastname: Tuygun
authors.forename: Ismail
authors.initials: I
authors.lastname: Nalbant
authors.forename: Muhammet Abdurrahim
authors.initials: MA
authors.lastname: Imamoglu
mesh_terms: D000328:Adult; D000792:Angiography; D001164:Arteriovenous Fistula / Q000209:etiology; D005471:Fluoroscopy; D006417:Hematuria / Q000175:diagnosis; D006454:Hemoglobins / Q000032:analysis / Q000737:chemistry; D006801:Humans; D007668:Kidney / Q000601:surgery*; D007669:Kidney Calculi / Q000601:surgery*; D007813:Laparotomy / Q000009:adverse effects* / Q000379:methods; D008096:Lithotripsy / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014652:Vascular Diseases / Q000209:etiology
chemical_list: D006454:Hemoglobins