Clinical analysis of ultrasound-guided "tract without bleeding vessel requiring embolization (TBVE)" in reducing bleeding during percutaneous nephrolithotomy.

IF 1.9 3区医学 Q3 UROLOGY & NEPHROLOGY

BMC Urology Pub Date : 2025-08-07 DOI:10.1186/s12894-025-01891-8

Zhipeng Wang, Lei Zhang, Liangwei Wan, Chen Wang, Xiaoqiang Liu, Jun Deng

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Abstract

Objective: To compare the efficacy of ultrasound-guided tract without bleeding vessel requiring embolization (TBVE) versus conventional minimally invasive access in mini-percutaneous nephrolithotomy (Mini-PCNL) for reducing postoperative bleeding.

Methods: This retrospective study analyzed 188 patients who underwent Mini-PCNL by a single surgeon between June 2021 and July 2023. Patients scheduled for mini-PCNL were assigned to two groups based on access technique. The first group had no TBVE (Standard mini-PCNL, n = 95) and the second group had TBVE (TBVE-assisted Standard mini-PCNL, n = 93). Baseline characteristics-including gender, age, body mass index (BMI), stone location, stone size, and preoperative hemoglobin levels-were balanced (P > 0.05). Perioperative outcomes were compared using t-tests and χ² tests.

Results: The TBVE-assisted mini-PCNL showed superior hemorrhage control, with significantly higher postoperative hemoglobin levels (111.32 ± 24.36 g/L vs. 120.13 ± 15.27 g/L, P < 0.05), smaller 24-hour hemoglobin declines (16.23 ± 15.27 g/L vs. 8.30 ± 7.21 g/L, P < 0.05), and fewer embolization-requiring events (6 vs. 1 case; P < 0.05). Operative time was comparable between groups (Mini-PCNL: 65.42 ± 34.97 min vs. TBVE: 67.73 ± 32.02 min, P > 0.05).

Conclusion: TBVE significantly reduces the risk of bleeding in Mini-PCNL compared to conventional access, as evidenced by reduced hemoglobin loss and fewer embolization requirements, without significantly prolonging operative time. This technique enhances procedural safety in the management of complex renal calculi.

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超声引导下“无出血血管栓塞（TBVE）道”减少经皮肾镜取石术出血的临床分析。

目的：比较超声引导下无出血血管栓塞（TBVE）与常规微创微创微创微创微创微创微创微创经皮肾镜取石术（Mini-PCNL）减少术后出血的效果。方法：本回顾性研究分析了2021年6月至2023年7月期间由一名外科医生接受Mini-PCNL的188例患者。计划进行mini-PCNL的患者根据进入技术分为两组。第一组无TBVE（标准mini-PCNL， n = 95），第二组有TBVE （TBVE辅助标准mini-PCNL， n = 93）。基线特征（包括性别、年龄、体重指数（BMI）、结石位置、结石大小和术前血红蛋白水平）平衡（P < 0.05）。围手术期预后比较采用t检验和χ 2检验。结果：tbve辅助mini-PCNL止血效果较好，术后血红蛋白水平明显提高（111.32±24.36 g/L vs. 120.13±15.27 g/L, P < 0.05）。结论：与常规通路相比，TBVE可显著降低Mini-PCNL的出血风险，血红蛋白损失减少，栓塞需求减少，且未显着延长手术时间。该技术提高了复杂性肾结石治疗的手术安全性。

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来源期刊

BMC Urology UROLOGY & NEPHROLOGY-

CiteScore

3.20

自引率

0.00%

发文量

177

审稿时长

>12 weeks

期刊介绍： BMC Urology is an open access journal publishing original peer-reviewed research articles in all aspects of the prevention, diagnosis and management of urological disorders, as well as related molecular genetics, pathophysiology, and epidemiology. The journal considers manuscripts in the following broad subject-specific sections of urology: Endourology and technology Epidemiology and health outcomes Pediatric urology Pre-clinical and basic research Reconstructive urology Sexual function and fertility Urological imaging Urological oncology Voiding dysfunction Case reports.