Тьє application of hemostatic matrix with tubeless execution percutaneus nephrolithotripsy

The application of hemostatic matrix with tubeless execution percutaneus nephrolithotripsy Nowadays percutaneous nephrolitothripsy (PCNL) is a standard therapeutic modality for large and staghorn kidney stones. Given that nephrostomy drainages could be a cause for pain and substantial discomfort, tubeless PCNL is considered to be a good alternative approach. The aim of our study was to evaluate the efficacy and safety of hemostatic matrix in patients with tubeless PCNL. Fifty-nine patients managed between 2009 and 2015 with tubeless PCNL were included in the study. All patients were divided between two groups: main group (n=29) has achieved the injection of hemostatic matrix in the percutaneous canal, and control group (n=30) without a hemostatic matrix. Following criteria were used for subsequent evaluation: blood loss, urine extravasation intensity from the percutaneous canal and severity of extravasation into the perirenal fat. The duration of the intervention was 49±5.3 min on average. Hemoglobin losses were comparable in both groups (p=0,23). Extravasation into the perinephral fat and that from the percutaneous canal was not significantly different between the groups. Clinically significant bleeding from the percutaneous access was not registered by any of the patients. We consider the hemostatic matrix an important preventive step of the active bleeding from the percutaneous canal in the early postoperative period, and also as the hermetization factor, which leads to the reduction of the probability of perinephral extravasation.