Vol. 3, Issue 1, Part A (2021)

Aim: We aimed to evaluate the perioperative parameters which can effect blood transfusion after percutaneous nephrolithotomy (PCNL). Material and Methods: Two hundred and seventy patients, who underwent PCNL between January 2017 and June 2020 in Departments of Urology, NevÅŸehir State Hospital, and Sultan Abdulhamid Han Education and Research Hospital, were evaluated retrospectively. Patients were divided into Groups I and II, according to whether or not blood transfusion was performed after PCNL, and perioperative parameters were compared. Results: There was no statistically significant difference between Group I and II in terms of age, gender, side of the stone, ipsilateral open stone surgery or PCNL history, presence of renal anatomic anomaly, preoperative hydronephrosis grade, stone size in computed tomography (CT), Hounds field Unit (HU) value, Guy's Stone Score (GSS), skin to stone distance, targeted calyx (upper, middle or lower), number of calyceal access, duration of operation, postoperative D-J insertion rate and postoperative fever (p >0.05). The riskiest period in terms of blood transfusion requirement after PCNL was determined as the first 24th and 76th hours (Relative risk for blood transfusion 26.7 and 105.73, respectively), [AUC = 0.87 (95% CI: 0.785-0.972)]. Conclusion: The only factor affecting blood transfusion after PCNL is the time needed to achieve limpid urine coming out of the nephrostomy. Post-PCNL bleeding coming out of the nephrostomy tube is a valuable parameter in terms of the blood transfusion requirement at the first 24 and 96th hours postoperatively. Close follow-up of the nephrostomy color using objective criteria can be used as a factor that can provide us with additional information in terms of transfusion requirements in addition to the patient's clinic, vital signs, and laboratory tests.