MP17-07 OUTCOMES OF CONSERVATIVE MANAGEMENT OF SPLENIC INJURY INCURRED DURING PCNL
Notice bibliographique
Résumé
You have accessJournal of UrologyStone Disease: Surgical Therapy II (MP17)1 Apr 2019MP17-07 OUTCOMES OF CONSERVATIVE MANAGEMENT OF SPLENIC INJURY INCURRED DURING PCNL Eric Raffin*, Ben Chew, Bodo Knudsen, Nicole Miller, and Vernon Pais Eric Raffin*Eric Raffin* More articles by this author , Ben ChewBen Chew More articles by this author , Bodo KnudsenBodo Knudsen More articles by this author , Nicole MillerNicole Miller More articles by this author , and Vernon PaisVernon Pais More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000555432.07297.c6AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Splenic injury is a rare complication after left sided percutaneous nephrolithotomy (PCNL). A total of only 11 occurrences have been reported in the literature. Although initial observation is often espoused, the outcomes of non-operative, conservative management are not well established and the implications of splenic injury are not fully defined in this context. We sought to describe outcomes of conservative management of splenic injury incurred at PCNL. METHODS: We performed a multi-institutional retrospective review of individual patients who underwent PCNL complicated by trans-splenic nephrostomy access injury. Demographic info, intraoperative data, management strategies, and outcomes were reviewed. RESULTS: There were a total of 6 patients with splenic injury after left PCNL. 67% were male. Average age was 49.8 years. Average BMI was 28.9 kg/m2. The average stone size was 42.6mm (range 12-91). All patients had at least one supracostal, upper pole access done under fluoroscopic guidance. Splenic injury was identified by CT in the 5 of 6 (83%) who had imaging on first postoperative day. All were managed conservatively with nephrostomy dwell time of 2-21 days, none of whom had further sequelae or delayed bleed. The remaining 1 patient (17%) – who had neither nephrostomy tube in place nor imaging post-op – presented 5 days postoperatively with a delayed bleed and underwent emergent splenectomy. CONCLUSIONS: The majority of patients incurring splenic injury during PCNL can be successfully managed conservatively with maintenance of nephrostomy tube for 2 days or greater. Although rare, this complication underscores the role of routine postoperative CT to allow timely diagnosis, particularly in those undergoing upper pole, supracostal left sided percutaneous renal access. Clinicians must remain vigilant for potential delayed bleeding during the first postoperative week and counsel patients accordingly. Source of Funding: None Lebanon, NH; Vancouver, Canada; Coumbus, OH; Nashville, TN; Lebanon, NH© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e257-e257 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Eric Raffin* More articles by this author Ben Chew More articles by this author Bodo Knudsen More articles by this author Nicole Miller More articles by this author Vernon Pais More articles by this author Expand All Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».