To identify the risk factors for severe bleeding requiring angioembolization among patients who received transfusions after PCNL, particularly those who underwent anatomically incorrect renal puncture. A total of 53 patients, who received transfusions after PCNL and simultaneously had a postoperative CT scan performed between November 2009 and May 2019 at two teaching hospitals, were retrospectively reviewed. The patients were divided into two groups: those who underwent angioembolization and those who did not. Patient, stone and procedural factors were compared between the two groups. Puncture correctness was evaluated using postoperative CT scans. Puncture was defined as being a correct puncture if the fornix or papilla of the posterior calyx was punctured and the trajectory of the tract was within 20 degrees posterior to the frontal plane of the kidney (i.e., within Brödel’s line). 21 patients underwent angioembolization after PCNL. Incorrect puncture was seen in 14/21 (66.7%) patients who underwent angioembolization after PCNL, whereas it was seen in 11/32 (34.4%) patients who did not undergo angioembolization (p = 0.021). On multivariable regression analysis, puncture correctness was found to be the only significant factor, with an OR of 3.818, 95% CI of 1.192–12.231 and p value of 0.024. Incorrect renal puncture was related to severe bleeding requiring angioembolization after PCNL. Our results emphasize the importance of the basic principle of renal puncture for PCNL.

中文翻译：

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经皮肾镜取石术后严重出血的关键原因需要血管栓塞

在PCNL后接受输血的患者中，特别是在解剖学上不正确的肾脏穿刺的患者中，确定需要血管栓塞的严重出血的危险因素。回顾性分析了2009年11月至2019年5月间在两家教学医院接受PCNL术后输血并同时进行了术后CT扫描的53例患者。将患者分为两组：进行血管栓塞的患者和未进行血管栓塞的患者。比较两组的患者，结石和手术因素。使用术后CT扫描评估穿刺正确性。如果刺穿了后萼的穹ni或乳头并且导管的运动轨迹位于肾脏额叶面后20度以内（即Brödel线内），则将穿刺定义为正确的穿刺。PCNL术后21例患者接受了血管栓塞术。在PCNL后进行血管栓塞的14/21（66.7％）患者中观察到不正确的穿刺，而在未进行血管栓塞的11/32（34.4％）患者中观察到不正确的穿刺（p = 0.021）。在多变量回归分析中，发现穿孔正确性是唯一的重要因素，OR为3.818，95％CI为1.192–12.231，p值为0.024。不正确的肾穿刺与PCNL后需要血管栓塞的严重出血有关。我们的结果强调了PCNL肾穿刺基本原理的重要性。在Brödel的范围内）。PCNL术后21例患者接受了血管栓塞术。在PCNL后进行血管栓塞的14/21（66.7％）患者中观察到不正确的穿刺，而在未进行血管栓塞的11/32（34.4％）患者中观察到不正确的穿刺（p = 0.021）。在多变量回归分析中，发现穿孔正确性是唯一的重要因素，OR为3.818，95％CI为1.192–12.231，p值为0.024。不正确的肾穿刺与PCNL后需要血管栓塞的严重出血有关。我们的结果强调了PCNL肾穿刺基本原理的重要性。在Brödel的范围内）。PCNL术后21例患者接受了血管栓塞术。在PCNL后进行血管栓塞的14/21（66.7％）患者中观察到不正确的穿刺，而在未进行血管栓塞的11/32（34.4％）患者中观察到不正确的穿刺（p = 0.021）。在多变量回归分析中，发现穿孔正确性是唯一的重要因素，OR为3.818，95％CI为1.192–12.231，p值为0.024。不正确的肾穿刺与PCNL后需要血管栓塞的严重出血有关。我们的结果强调了PCNL肾穿刺基本原理的重要性。4％）未接受血管栓塞的患者（p = 0.021）。在多变量回归分析中，发现穿孔正确性是唯一的重要因素，OR为3.818，95％CI为1.192–12.231，p值为0.024。不正确的肾穿刺与PCNL后需要血管栓塞的严重出血有关。我们的结果强调了PCNL肾穿刺基本原理的重要性。4％）未接受血管栓塞的患者（p = 0.021）。在多变量回归分析中，发现穿孔正确性是唯一的重要因素，OR为3.818，95％CI为1.192–12.231，p值为0.024。不正确的肾穿刺与PCNL后需要血管栓塞的严重出血有关。我们的结果强调了PCNL肾穿刺基本原理的重要性。