Med Bull Sisli Etfal Hosp. 2023; 57(3): 346-352 | DOI: 10.14744/SEMB.2023.63904

Surgical Delay Increases the Perioperative Blood Transfusion Rate in Percutaneous Nephrolithotomy

Yusuf Sahin¹, Mehmet Yilmaz¹, Enes Kilic², Ahmet Yaser Muslumanoglu^1
1Department of Urology, University of Health Sciences Türkiye, Bagcilar Training and Research Hospital, Istanbul, Türkiye
²Deparment of Urology, Zonguldak Atatürk State Hospital, Zonguldak, Türkiye

Objectives: We aimed to investigate the effect of prolonged time from diagnosis to treatment (TDT) on surgical outcomes in patients undergoing percutaneous nephrolithotomy (PNL).
Methods: This study included a total of 544 patients who underwent PNL in our clinic between November 2017 and November 2021. Clinicodemographical, radiological, and perioperative data of the patients were recorded. The stone-free rate as assessed by abdominal computed tomography at 3 months was estimated. The possible relation of the stone-free rate and perioperative complications with TDT was examined.
Results: The median age was 48 (range, 38–58) years, the median stone size was 405 (range, 250–700) mm2, and the median stone density was 1,000 (range, 730–1,221) Hounsfield units. The median TDT was 75 (range, 42–133) days. Twenty-seven patients (5.0%) required perioperative blood transfusion (PBT). There was a statistically significant correlation between TDT and the need for PBT (p=0.022). However, there was no significant correlation between TDT and stone-free rate (p>0.05). Using a cutoff value of 90.5 days, TDT could predict the need for PBT with 59.3% sensitivity and 60% specificity.
Conclusion: Our study results suggest that the need for PBT increases in patients undergoing PNL longer than 90.5 days after the diagnosis. However, further large-scale, prospective studies are warranted to elucidate the effect of prolonged TDT on surgical outcomes in this patient population.

Keywords: Blood transfusion, percutaneous nephrolithotomy, time to treatment

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Cerrahi Tedavide Gecikme Perkütan Nefrolitotomide Perioperatif Kan Transfüzyon Oranýný Artýrýr

Yusuf Sahin¹, Mehmet Yilmaz¹, Enes Kilic², Ahmet Yaser Muslumanoglu^1
1Türkiye Saðlýk Bilimleri Üniversitesi, Baðcýlar Eðitim ve Araþtýrma Hastanesi, Üroloji Anabilim Dalý, Ýstanbul
²Zonguldak Atatürk Devlet Hastanesi, Üroloji Anabilim Dalý, Zonguldak

Amaç: Perkütan nefrolitotomi (PNL) yapýlan hastalarda tanýdan tedaviye kadar geçen süredeki (TTS) uzamanýn cerrahi sonuçlara etkisini araþtýrdýk.
Materyal ve metod: Kasým 2017 ile kasým 2021 tarihleri arasýnda PNL yapýlan 544 hastanýn demografik, radyolojik ve peroperatif klinik bilgileri kaydedildi. Hastalarýn 3. ay batýn tomografisine göre taþsýzlýk oranlarý ve peroperatif komplikasyonlar ile TTS arasýndaki iliþki istatistiksel yöntemlerle araþtýrýldý.
Bulgular: Hastalarýn median yaþý 48 (38-58), taþ boyutu 405 (250-700) mm2, dansitesi ise 1000 (730-1221) Hounsfield Unit idi. TTS median deðeri 75 (42-133) gün idi. 27 (5,0 %) hastaya peroperatif kan transfüzyonu uygulandý. TTS ile peroperatif kan transfüzyonu oraný arasýnda istatistiksel olarak anlamlý farklýlýk saptandý (p=0,022). TTS ile taþsýzlýk oranlarý ve genel komplikasyon oranlarý arasýnda anlamlý farklýlýk saptanmadý. TTS cut-off deðeri (90,5 gün) kan transfüzyonu yapýlma ihtimalini tahmin etmede 59,3% sensitivite ve 60% spesifite deðerlerine sahipti.
Sonuç: PNL yapýlan hastalarda TTS 90,5 günü geçtiðinde peroperatif kan transfüzyon oraný artmaktadýr. TTS’deki uzamanýn PNL’nin cerrahi sonuçlarý üzerine etkisinin daha net anlaþýlmasý için geniþ çaplý ve yüksek kanýt düzeyinde çalýþmalara ihtiyaç vardýr. (SETB-2023-02-028)

Anahtar Kelimeler: Kan transfüzyonu, perkütan nefrolitotomi, tedaviye kadar geçen süre

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