Calculi migration into the left renal vein during percutaneous nephrolithotomy: a rare complication and literature review

Öz

Percutaneous nephrolithotomy (PCNL) has long been the standard treatment of choice for the management of large and complex renal calculi. PCNL is a safe and well-tolerated surgical procedure when performed systematically and correctly; however, as with any surgical intervention, although mild complications may occur in this surgery, serious complications may also occur. In this article, we report a rare case of migration of residual calculi into the renal vein during PCNL surgery and aim to present its presentation, treatment and management in a tertiary care center.

Anahtar Kelimeler

• percutaneous nephrolithotomy
• renal vein injury
• thrombosis
• anticoagulant therapy

Perkütan nefrolitotomi esnasında sol renal vene kalkül migrasyonu: nadir bir komplikasyon ve literatür taraması

Öz

Üriner sistem taş hastalıklarının cerrahi tedavisinde perkütan nefrolitotomi (PCNL) ameliyatı, uzun yıllardır büyük hacimli ve kompleks böbrek taşlarının tedavisinde sık tercih edilen standart bir tedavi haline gelmiştir. PCNL sistematik ve doğru şekilde yapıldığında güvenilir ve iyi tolere edilebilen cerrahi bir prosedürdür; ancak herhangi bir cerrahi müdahalede olduğu gibi bu ameliyatta da basit olmakla beraber ciddi komplikasyonlar da gelişebilmektedir. Bu yazıda, PCNL ameliyatı sırasında rezidü kalkülün renal vene migrasyonu olan nadir bir olguyu sunarak bunun üçüncü basamak bir merkezde ortaya çıkışını, tedavisini ve nasıl yönetildiğini sunmayı amaçladık.

Anahtar Kelimeler

• perkütan nefrolitotomi,
• renal ven yaralanması
• trombozis
• antikoagülan tedavi

Kaynakça

1. 1. Fernström I, Johansson B. Percutaneous pyelolithotomy. A new extraction technique. Scand J Urol Nephrol 1976;10:257-259. https://doi.org/10.1080/21681805.1976.11882084
2. 2. Rudnick DM, Stoller ML. Complications of percutaneous nephrostolithotomy. Can J Urol 1999;6:872-875.
3. 3. de la Rosette J, Assimos D, Desai M, et al. The clinical research office of the endourological society percutaneous nephrolithotomy global study: indications, complications, and outcomes in 5803 patients. J Endourol 2011;25:11-17. https://doi.org/10.1089/end.2010.0424
4. 4. Shin TS, Cho HJ, Hong SH, Lee JY, Kim SW, Hwang TK. Complications of percutaneous nephrolithotomy classified by the modified clavien grading system: a single center's experience over 16 years. Korean J Urol 2011;52:769-775. https://doi.org/10.4111/kju.2011.52.11.769
5. 5. Galek L, Darewicz B, Werel T, Darewicz J. Haemorrhagic complications of percutaneous lithotripsy: original methods of treatment. Int Urol Nephrol 2000;32:231-233. https://doi.org/10.1023/a:1007126900772
6. 6. Poudyal S. Current insights on haemorrhagic complications in percutaneous nephrolithotomy. Asian J Urol 2022;9:81-93. https://doi.org/10.1016/j.ajur.2021.05.007
7. 7. Klein I, Gutiérrez Aceves J. Preoperative imaging in staghorn calculi, planning and decision making in management of staghorn calculi. Asian J Urol 2020;7:87-93. https://doi.org/10.1016/j.ajur.2019.07.002
8. 8. Sampaio FJ. The dilemma of the crossing vessel at the ureteropelvic junction: precise anatomic study. J Endourol 1996;10:411-415. https://doi.org/10.1089/end.1996.10.411

9. 9. Zhang LW, Fei X, Song Y. The clinical efficacy of novel vacuum suction ureteroscopic lithotripsy in the treatment of upper ureteral calculi. World J Urol 2021;39:4261-4265. https://doi.org/10.1007/s00345-021-03722-5
10. 10. Nunes TF, Tibana TK, Santos RFT, Carramanho Junior JDC, Marchiori E. Percutaneous insertion of bilateral double J stent. Radiol Bras 2019;52:104-105. https://doi.org/10.1590/0100-3984.2017.0230
11. 11. Coccolini F, Moore EE, Kluger Y, et al. Kidney and uro-trauma: WSES-AAST guidelines. World J Emerg Surg 2019;14:54(e1-25). https://doi.org/10.1186/s13017-019-0274-x
12. 12. Aggarwal A, Bhargava P, Bhirud DP. Renal vein injury during percutaneous nephrolithotomy: a surgical catastrophe - Management and lessons learned. Indian J Urol 2022;38:309-311. https://doi.org/10.4103/iju.iju_241_22
13. 13. Ge G, Wang Z, Wang M, Li G, Xu Z, Wang Y, Wan S. Inadvertent insertion of nephrostomy tube into the renal vein following percutaneous nephrolithotomy: a case report and literature review. Asian J Urol 2020;7:64-67. https://doi.org/10.1016/j.ajur.2018.06.003
14. 14. Zumrutbas AE, Toktas C, Baser A, Tuncay OL. Percutaneous nephrolithotomy in rare bleeding disorders: a case report and review of the literature. J Endourol Case Rep 2016;2:198-203. https://doi.org/10.1089/cren.2016.0105
15. 15. Martin X, Murat FJ, Feitosa LC, et al. Severe bleeding after nephrolithotomy: results of hyperselective embolization. Eur Urol 2000;37:136-139. https://doi.org/10.1159/000020129