Efficacy and safety of minimally invasive percutaneous nephrolithotomy in patients on anticoagulant therapy

doi:10.3877/cma.j.issn.1674-3253.2020.01.012

Abstract

Abstract:

Objective

To assess the efficacy and safety of minimally invasive percutaneous nephrolithotomy(MPCNL) in treatment of patients receiving anticoagulant therapy.

Methods

Forty seven patients receiving long term anticoagulant therapy and diagnosis as upper urinary tract calculi underwent MPCNL in the Third Affiliated Hospital of Sun Yat-sen University between June 2015 and October 2017, and defined as Group A. Oral anticoagulant medicine was replaced by low molecular heparin in perioperative period , and balloon catheter was applied as nephrostomy tube postoperatively. Fifty patients diagnosis as upper urinary tract calculi, without blood coagulation disorders and had not received anticoagulant therapy were recruited as control group, and received MPCNL in the meantime, defined as Group B. General condition, operative time, stone free rate, blood loss, hospital stay and complications were compared between the two groups.

Result

No significant difference was found in operative time, stone free rate, bloom loss and complications between the two groups. Hospital stay in Group A was longer than that in Group B, but no significant difference was found in postoperative hospital stay between the two groups.

Conclusion

MPCNL is effective and safe in treatment for patients receiving long term anticoagulant therapy, while adequate preparation was made in perioperative period.

Key words: Minimally invasive, Percutaneous nephrolithotomy, Calculi, Anticoagulant

Wenbiao Li, Wanwen Lin, Wenjun Xie, Hailun Zhan, Xiangfu Zhou, Fei Yang. Efficacy and safety of minimally invasive percutaneous nephrolithotomy in patients on anticoagulant therapy[J]. Chinese Journal of Endourology(Electronic Edition), 2020, 14(01): 48-51.

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Figures/Tables 2

References 15

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组别	例数	性别（例）		年龄（岁，±s）	BMI（kg/m²，±s）	结石侧别（例）		结石多少（例）		结石大小（cm，±s）
组别	例数	男	女	年龄（岁，±s）	BMI（kg/m²，±s）	左侧	右侧	单发	多发	结石大小（cm，±s）
抗凝组	47	27	20	62±8	25.5±3.1	21	26	36	11	1.51±0.42
非抗凝组	50	26	24	60±7	24.7±3.3	25	25	39	11	1.48±0.38
统计值	?	χ²=0.290		t=1.174	t=1.229	χ²=0.275		χ²=2.724		t=0.369
P值	?	0.590		0.243	0.222	0.600		0.869		0.713

组别	例数	性别（例）		年龄（岁，±s）	BMI（kg/m²，±s）	结石侧别（例）		结石多少（例）		结石大小（cm，±s）
组别	例数	男	女	年龄（岁，±s）	BMI（kg/m²，±s）	左侧	右侧	单发	多发	结石大小（cm，±s）
抗凝组	47	27	20	62±8	25.5±3.1	21	26	36	11	1.51±0.42
非抗凝组	50	26	24	60±7	24.7±3.3	25	25	39	11	1.48±0.38
统计值	?	χ²=0.290		t=1.174	t=1.229	χ²=0.275		χ²=2.724		t=0.369
P值	?	0.590		0.243	0.222	0.600		0.869		0.713

组别	例数	手术时间（min，±s）	Hb下降（g/L，±s）	结石清除率[例（%）]	住院时间（d，±s）	术后住院时间（d，±s）	并发症（例）
组别	例数	手术时间（min，±s）	Hb下降（g/L，±s）	结石清除率[例（%）]	住院时间（d，±s）	术后住院时间（d，±s）	发热	心脑血管并发症	输血	血栓形成
抗凝组	47	59±9	8.6±2.1	49（91.5）	18.2±2.1	7.6±1.1	4	0	3	0
非抗凝组	50	57±8	7.9±2.3	46（92.0）	11.5±1.8	7.3±1.2	5	0	2	0
统计值	?	t=1.021	t=1.562	χ²=7.723	t=16.903	t=1.281	χ²=9.50	-	χ²=5.05	-
P值	?	0.310	0.122	0.781	<0.01	0.203	0.922	-	0.943	-

组别	例数	手术时间（min，±s）	Hb下降（g/L，±s）	结石清除率[例（%）]	住院时间（d，±s）	术后住院时间（d，±s）	并发症（例）
组别	例数	手术时间（min，±s）	Hb下降（g/L，±s）	结石清除率[例（%）]	住院时间（d，±s）	术后住院时间（d，±s）	发热	心脑血管并发症	输血	血栓形成
抗凝组	47	59±9	8.6±2.1	49（91.5）	18.2±2.1	7.6±1.1	4	0	3	0
非抗凝组	50	57±8	7.9±2.3	46（92.0）	11.5±1.8	7.3±1.2	5	0	2	0
统计值	?	t=1.021	t=1.562	χ²=7.723	t=16.903	t=1.281	χ²=9.50	-	χ²=5.05	-
P值	?	0.310	0.122	0.781	<0.01	0.203	0.922	-	0.943	-

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