Presented by: Sung Yong Cho Professor
Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine

Introduction

Kidney hemorrhage is one of the most common and significant complications of tubeless miniaturized percutaneous nephrolithotomy (mPCNL). This study aimed to evaluate the effectiveness and safety of hemostasis in mPCNL using monopolar electrocautery in the percutaneous tract bleeding.

Materials

We prospectively enrolled 200 consecutive patients (presenting to a single institution and) classified them into two groups. The experimental group consisted of 28 patients receiving monopolar coagulation for the percutaneous tract. The control group included 172 patients in whom fulguration was not done. Perioperative outcomes were compared between the groups.

Results

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There was no statistical difference in operative times and transfusion rates between the two groups. However, patients who received electrocauterization demonstrated a statistically significant decrease in the rate of angiography procedures. Additionally, these patients experienced a significantly shortened duration of double J stent placement and rapid recovery of hemoglobin levels, particularly in cases of significant bleeding. Notably, no significant complications were observed in either group.

Conclusion

These findings suggest that the use of monopolar electrocauterization effectively reduces the risk of postoperative bleeding and alleviates the burden on patients who may require additional blood transfusions by providing effective hemostasis during tubeless mPCNL.

Funding

This work was supported by the National Research Foundation of Korea(NRF) grant funded by the Korea government(MEST) (No. 2022R1F1A1059835) and the Korea Medical Device Development Fund grant funded by the Korea government (the Ministry of Science and ICT) (Project Number: 1711194216 , RS-2020-KD000010).

Lead Authors

Sung Yong Cho,
Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine

Co-Authors

Chinnakhet Ketsuwan,
Division of Urology, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University

Hyeji Park,
Department of Urology, Seoul National University Hospital