Comparison of Two Treatment Methods “One Shot” and “Sequential” on Reduction the Level of Hemoglobin in Patients with Percutaneous Nephrolithotripsy in Al Zahra Hospital in 2012–2013

Khorrami, Mohammad Hatef; Izadpanahi, Mohammad Hossein; Mohammadi, Mehrdad; Alizadeh, Farshid; Zargham, Mahtab; Khorrami, Farbod; Isfahani, Felora Farahini

Comparison of Two Treatment Methods “One Shot” and “Sequential” on Reduction the Level of Hemoglobin in Patients with Percutaneous Nephrolithotripsy in Al Zahra Hospital in 2012–2013

Document Type : Original Article

Authors

¹ Department of Urology, Isfahan University of Medical Sciences, Isfahan, Iran

² Department of Biology, A. Y. Jackson Secondary School, Toronto, Ontario, Canada

³ Isfahan Kidney Transplantation Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Access dilation is the most important part of percutaneous nephrolithotripsy (PCNL) that is done by different methods, especially metal telescoping and one shot. In this study, two different methods of access dilation one shot and telescoping were compared. Materials and Methods: In observational cross-sectional study, 240 patients who were a candidate for PCNL were selected and randomly divided into two groups. The first group was undergone one-shot method and the second group was undergone telescoping method. The decrease in hemoglobin (Hb), duration of hospitalization and the time of radiation exposure during access dilation was compared in two groups by SPSS software version 21, (SPSS Inc., Chicago, IL, USA). Results: The decrease of Hb level after intervention in one-shot group was 1.08 ± 1.23 g/dl and in telescoping, group was 1.51 ± 1.08 g/dl with no difference statistically (P = 0.37). The mean duration of hospitalization in one shot and telescoping group were 2.36 ± 0.67 and 2.28 ± 0.61 days, respectively. According to t-test, there was no significant difference between the two groups (P = 0.37). Average radiation exposure in one shot group was 7.13 s and in telescoping, group was 35.75 s, and there was a significant difference between the two groups (P < 0.001). Conclusion: One-shot method is superior to telescoping method due to less time for radiation exposure and no more blood loss and other complications during PCNL.

Keywords

References

1.	Mani M, Bhalchondra G. Urinary lithiasis. In: Walsh PC, Retik AB, Stamey TA, Vaughan EJ, editors. Campbell's Urology. Vol. 3, Ch. 91. Philadelphia: W.B. Saunders Company; 1988.
2.	Healy KA, Ogan K. Nonsurgical management of urolithiasis: An overview of expulsive therapy. J Endourol 2005;19:759-67. [PUBMED]
3.	Preminger GM, Assimos DG, Lingeman JE, Nakada SY, Pearle MS, Wolf JS Jr.; AUA Nephrolithiasis Guideline Panel. Chapter 1: AUA guideline on management of staghorn calculi: Diagnosis and treatment recommendations. J Urol 2005;173:1991-2000.
4.	Teichman JM, Long RD, Hulbert JC. Long-term renal fate and prognosis after staghorn calculus management. J Urol 1995;153:1403-7. [PUBMED]
5.	Emmons L, Kiely T, Roberts B. Report on the Management of Staghorn Calculi; October, 2007. Available from: http://www. Auanet.rog/guidelines/main-reports/stagcalmain.pdf. [Last accessed on 2014 Feb 11].
6.	Rassweiler JJ, Renner C, Eisenberger F. The management of complex renal stones. BJU Int 2000;86:919-28. [PUBMED]
7.	Preminger G. Managment of Struvite or Staghorn Calculi; October, 2007. Available from: CD Uptodate; 2007. Available from: www.uptodate.com/contents/management-of-struvite-or-staghorn-calculi. [Last accessed on 2013 Dec 18].
8.	Koko AH, Onuora VC, Al-Turkey MA, Al Moss M, Meabed AH, Al Jawani NA. Percutaneous nephrolithotomy for complete staghorn renal stones. Saudi J Kidney Dis Transpl 2007;18:47-53. [PUBMED] [Full text]
9.	Al-Kohlany KM, Shokeir AA, Mosbah A, Mohsen T, Shoma AM, Eraky I, et al. Treatment of complete staghorn stones: A prospective randomized comparison of open surgery versus percutaneous nephrolithotomy. J Urol 2005;173:469-73.
10.	Stoller ML, Wolf JS, Lezin MA. Estimated blood loss and transfusion rates associated with percutaneous nephrolithotomy. J Endourol 2002;16:221-4.
11.	Skolarikos A, Papatsoris AG. Diagnosis and management of postpercutaneous nephrolithotomy residual stone fragments. J Endourol 2009;23:1751-5.
12.	Myles P. Antifibrinolytic therapy: Evidence, bias, confounding (and politics!). J Extra Corpor Technol 2007;39:308-10.
13.	Rastinehad AR, Andonian S, Smith AD, Siegel DN. Management of hemorrhagic complications associated with percutaneous nephrolithotomy. J Endourol 2009;23:1763-7.
14.	Faas CL, Acosta FJ, Campbell MD, O'Hagan CE, Newton SE, Zagalaniczny K. The effects of spinal anesthesia vs. epidural anesthesia on 3 potential postoperative complications: Pain, urinary retention, and mobility following inguinal herniorrhaphy. AANA J 2002;70:441-7.
15.	Davis FM, McDermott E, Hickton C, Wells E, Heaton DC, Laurenson VG, et al. Influence of spinal and general anaesthesia on haemostasis during total hip arthroplasty. Br J Anaesth 1987;59:561-71.
16.	Salonia A, Crescenti A, Suardi N, Memmo A, Naspro R, Bocciardi AM. General versus spinal anesthesia in patients undergoing radical retropubic prostatectomy: Results of a prospective, randomized study. Int J Urol 2006;13:1185-90.
17.	Abbou CC, Belas M, Kouri G, Bottine Y, Lille P, Auvert J. Percutaneous nephrolithotomy in 1984. Technics, results, indications. Ann Urol (Paris) 1984;18:371-80.
18.	Corbel L, Guillé F, Cipolla B, Staerman F, Leveque JM, Lobel B. Percutaneous surgery for lithiasis: Results and perspectives. Apropos of 390 operations. Prog Urol 1993;3:658-65.
19.	Amjadi M, Zolfaghari A, Elahian A, Tavoosi A. Percutaneous nephrolithotomy in patients with previous open nephrolithotomy: One-shot versus telescopic technique for tract dilatation. J Endourol 2008;22:423-5.
20.	Lojanapiwat B. The ideal puncture approach for PCNL: Fluoroscopy, ultrasound or endoscopy? Indian J Urol 2013;29:208-13. [PUBMED] [Full text]
21.	Hellawell GO, Mutch SJ, Thevendran G, Wells E, Morgan RJ. Radiation exposure and the urologist: What are the risks? J Urol 2005;174:948-52.
22.	Mancini JG, Raymundo EM, Lipkin M, Zilberman D, Yong D, Bañez LL, et al. Factors affecting patient radiation exposure during percutaneous nephrolithotomy. J Urol 2010;184:2373-7.
23.	Majidpour HS. Risk of radiation exposure during PCNL. Urol J 2010;7:87-9.

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