Subcapsular renal hematoma after ureteroscopy with holmium:yttrium-aluminum-garnet laser lithotripsy

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• 作者：Wei Tao ; Chun Jie Cai ; Chuan Yang Sun ; Bo Xin Xue ; Yu Xi Shan
• 关键词：Hematoma ; Ureteroscopic lithotripsy ; Laser
• 刊名：Lasers in Medical Science
• 出版年：2015
• 出版时间：July 2015
• 年：2015
• 卷：30
• 期：5
• 页码：1527-1532
• 全文大小：1,220 KB
• 参考文献：1.Seitz C, Tanovic E, Kikic Z, Fajkovic H (2007) Impact of stone size, location, composition, impaction, and hydronephrosis on the efficacy of holmium:YAG-laser ureterolithotripsy. Eur Urol 52:1751-757PubMed View Article
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• 作者单位：Wei Tao (1)
  Chun Jie Cai (1)
  Chuan Yang Sun (1)
  Bo Xin Xue (1)
  Yu Xi Shan (1)
  
  1. Department of Urology, The Second Affiliated Hospital of Soochow University, Suzhou, China
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Medicine/Public Health, general
  Dentistry
  Laser Technology and Physics and Photonics
  Quantum Optics, Quantum Electronics and Nonlinear Optics
  Applied Optics, Optoelectronics and Optical Devices
  
• 出版者：Springer London
• ISSN：1435-604X

文摘

Subcapsular renal hematoma (SRH) after ureteroscopic lithotripsy (URSL) using holmium:yttrium-aluminum-garnet (Ho:YAG) laser to treat ureteric stones is a rare complication. We aimed to review our unit’s experience of post-URSL subcapsular renal hematoma. From 2006 to 2012, 2059 URSLs using F9.5 rigid ureteroscope were performed in our unit. Patients with post-URSL symptomatic renal hematoma were reviewed. Perioperative information on patients-renal function, stone characteristics, and degree of renal hydronephrosis were reviewed. Operative data, postoperative information such as clinical manifestation, changes in blood parameters, CT findings, and subsequent treatment were documented. Of the 2059 patients treated with URSL and Ho:YAG laser, three patients were diagnosed as subcapsular renal hematoma after surgery; the age is 57, 61, and 63?years old, respectively. Preoperative imaging examination showed that two patients and one patient had obstructing middle and proximal ureteral stones ranging in size from 0.8 to 1.6?cm, and three patients had thin renal cortices. The double-J ureteral stents were inserted in all cases regularly. All three subcapsular renal hematoma patients had the loin pain of the operation side and fever, and one patient had significant hemoglobin drop (from 111 to 61?g/L) who need to transfusion. Two patients presented within 24?h of URSL, and one patient presented on day 10. One patient was treated conservatively for 3?weeks and recovered with bed rest, antibiotics, hemostasis, and analgesia with no intervention or drain. The other two patients underwent ultrasonography-guided drainage of the hematoma. Two-month follow-up CT scans or ultrasonography confirmed the resolution of the hematoma in all three cases. Renal subcapsular hematoma after URSL is a rare and one of serious complications. Subcapsular renal hematoma should be considered when patients have the symptoms of significant loin pain after URSL for obstructing ureteral stones with thin renal cortices. The treatment of post-URSL renal subcapsular hematomas needs to be customized for each patient.