Causes of open surgery during or after percutaneous renal surgery

Lee, Dong Hwan; Hwang, Tae Kon; Park, Yong Hyun

Abstract

Of the 443 patients who underwent percutaneous renal surgery at our hospital, 24 patients(5.4% ) required open surgery. We evaluated the causes of open surgery and their operative methods in those patients. The most common cause of open surgery was inadequate puncture(10 patients)into the posterior calyx. The remainders were severe bleeding(5 patients), difficulties in fragmentation (4 patients), embedded stones( 3 patients), downward migration of stone(1 patient) and poor renal function(1 patient). Their operative methods were pyelolithotomy(9 patients),ureterolithotomy(9 patients), nephrolithotomy(1 patient), nephrectomy(3 patients) and partial nephrectomy(2 patients). Two patients who showed delayed bleeding underwent nephrectomy, because bleeding was continued in spite of conservative management or selective angioinfarction. We believe that problems and complications may occur at any point in the percutaneous renal surgery and as with other open surgery, knowledge of what complications may occur and which method is the best way to solve them will assist in their prevention and awareness of how to manage suck complicatioins will minimize their impact.