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Complicatıons in Percutaneous Nephrolithotomy and Management

Yıl 2019, Cilt: 2 Sayı: 2, 107 - 117, 31.08.2019

Mutlu Deger İbrahim Atilla Arıdogan

Öz

Kidney stone disease is very common in the world. Although percutaneous nephrolithotomy (PCNL) is the gold standard surgical treatment for renal stones larger than 2 cm, complication rates of 20% to 83% have been reported. Complications of PCNL procedure include bleeding, sepsis, injury to the collecting system, injury to adjacent organs such as colon, small intestine, thoracic, liver, gallbladder and spleen, and death. These complications are minimized by choosing an appropriate patient and good preoperative evaluations. As experience increases, the complication rate decreases. The most important is the early identification of the complication. Major complications can be solved with conservative and minimally invasive methods.

 

In this review, we discussed the complications and their management of PCNL.

Anahtar Kelimeler

Kidney Kidney Stone Percutanous Nephrolithotomy Complication

Kaynakça

  • Referans1. Sorokin I, Mamoulakis C, Miyazawa K, Rodgers A, Talati J, Lotan Y. Epidemiology of stone disease across the World. World J Urol. 2017 Sep;35(9):1301-1320. doi: 10.1007/s00345-017-2008-6.
  • Referans2. Ogg CS, Saxton HM, Cameron JS. Percutaneous needle nephrostomy. Br Med J. 1969; 4:657-60.
  • Referans3. Alken P, Hutschenreiter G, Guenther R. Percutaneous kidney stone removal. EurUrol. 1982; 8:304–11.
  • Referans4. Hafron J, Fogarty JD, Boczko D, Hoenig DM. Combined ureterorenoscopy and shock wave lithotripsy for large renal stone burden: an alternative to percutaneous nephrolithotomy? J Endourol 2005; 19:464–8.
  • Referans5. Marguet CG, Springhart WP, Tan YH, et al. Simultaneous combined use of flexible ureteroscopy and percutaneous nephrolithotomy to reduce the number of access tracts in the management of complex renal calculi. BJU Int 2005; 96:1097–100.
  • Referans6. Türk C, Knoll T, Petrik A et al. European association of urology, guidelines on urolithiasis. Eur Urol 2015; 69:468.
  • Referans7. Taylor E, Miller J, Chi T, Stoller ML. Complications associated with percutaneous nephrolithotomy. Transl Androl Urol. 2012 Dec; 1(4):223-8. doi: 10.3978/j.issn.2223-4683.2012.12.01.
  • Referans8. Michel MS, Trojan L, Rassweiler JJ. Complications in Percutaneous Nephrolithotomy. Eur Urol. 2007 Apr;51(4):899-906; discussion 906. Epub 2006 Oct 25. Review.
  • Referans9. 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; 25:11-7.
  • Referans10. Shin TS, Cho HJ, Hong SH, et al. Complications of Percutaneous Nephrolithotomy Classified by the Modified Clavien Grading System: A Single Center’s Experienceover 16 Years. Korean J Urol 2011; 52:769-75.
  • Referans11. Skolarikos A, de la Rosette J. Prevention and treatment of complications following percutaneous nephrolithotomy. Curr Opin Urol 2008; 18: 229-34.
  • Referans12. Tonolini M, Villa F, Ippolito S, et al. Cross-sectional imaging of iatrogenic complications after extracorporeal and endourological treatment of urolithiasis. Insights Imaging 2014; 5:677–689.
  • Referans13. Clayman RV, Surya V, Hunter D, Castaneda-Zuniga WR, Miller RP, Coleman C et al. Renal vascular complications associated with the percutaneous removal of renal calculi. J Urol 1984;132(2):228–230.
  • Referans14. Lang EK. Percutaneous nephrostolithotomy and lithotripsy: a multi-institutionalsurvey of complications. Radiology1987;162(1 Pt 1):25–30.
  • Referans15. Roth RA, Beckmann CF. Complications of extracorporeal shock-wave lithotripsy and percutaneous nephrolithotomy. Urol Clin N Am1988;15(2):155–166.
  • Referans16. Srivastava A, Singh KJ, Suri A, Dubey D, Kumar A, Kapoor R et al. Vascular complications after percutaneous nephrolithotomy: are there any predictive factors? Urology 2005 66(1):38–40.
  • Referans17. Stoller ML, Wolf JS Jr, StLezin MA. Estimated blood loss and transfusion rates associated with percutaneous nephrolithotomy. J Urol 1994; 152(6 Pt 1):1977–1981.
  • Referans18. El-Nahas AR, Shokeir AA, El-Assmy AM, Mohsen T, Shoma AM, Eraky I et al. Post percutaneous nephrolithotomy extensive hemorrhage: a study of risk factors. J Urol 2007;177(2):576–579.
  • Referans19. Kukreja R, Desai M, Patel S, Bapat S, Desai M. Factors affecting blood loss during percutaneous nephrolithotomy: prospective study. J Endourol 2004;18(8):715–722.
  • Referans20. Said SH, Al Kadum Hassan MA, Ali RH, Aghaways I, Kakamad FH, Mohammad KQ. Percutaneous nephrolithotomy; alarming variables for postoperative bleeding. Arab J Urol2017;15(1):24–29.
  • Referans21. Turna B, Nazli O, Demiryoguran S, Mammadov R, Cal C. Percutaneous nephrolithotomy: variables that influence hemorrhage. Urology 2007;69(4):603–607.
  • Referans22. Assimos D, Krambeck A, Miller NL, Monga M, Murad MH, Nelson CP et al. Surgical management of stones: American Urological Association/Endourological Society Guideline, PART I. J Urol 2016;196(4):1153–1160.
  • Referans23. Leavitt DA, Theckumparampil N, Moreira DM, Elsamra SE, Waingankar N, Hoenig DM et al. Continuing aspirin therapy during percutaneous nephrolithotomy: unsafe or underutilized? J Endourol 2014;28(12):1399–1403.
  • Referans24. Culkin DJ, Exaire EJ, Green D, Soloway MS, Gross AJ, Desai MR et al. Anticoagulation and antiplatelet therapy in urological practice: ICUD/AUA review paper. J Urol2014;192(4):1026–1034.
  • Referans25. Mahaffey KG, Bolton DM, Stoller ML. Urologist directed percutaneous nephrostomy tube placement. J Urol 1994;152(6 Pt 1):1973–1976.
  • Referans26. Davidoff R, Bellman GC. Influence of technique of percutaneous tract creation on incidence of renal hemorrhage. J Urol. 1997; 157(4):1229–1231.
  • Referans27. Yamaguchi A, Skolarikos A, Buchholz NP, Chomon GB, Grasso M, Saba P et al. Operating times and bleeding complications in percutaneous nephrolithotomy: a comparison of tract dilation methods in 5537 patients in the Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study. J Endourol. 2011; 25(6):933–939.
  • Referans28. Li Y, Yang L, Xu P, Shen P, Qian S, Wei W et al. One-shot versus gradual dilation technique for tract creation in percutaneous nephrolithotomy: a systematic review and meta-analysis. Urolithiasis. 2013;41(5):443–448.
  • Referans29. Srivastava A, Singh S, Dhayal IR, Rai P.A prospective randomized study comparing the four tract dilation methods of percutaneous nephrolithotomy. World J Urol. 2017;35(5):803–807.
  • Referans30. Karakose A, Aydogdu O, Atesci YZ. Does the use of smaller Amplatz sheath size reduce complication rates in percutaneous nephrolithotomy? Urol J. 2014;11(4):1752–1756.
  • Referans31. Wollin DA, Preminger GM. Percutaneous nephrolithotomy: complications and how to deal with them. Urolithiasis. 2018 Feb;46(1):87-97. doi: 10.1007/s00240-017-1022-x. Epub 2017 Nov 17. Review.
  • Referans32. Cormio L, Preminger G, Saussine C, Buchholz NP, Zhang X, Walfridsson H et al. Nephrostomy in percutaneous nephrolithotomy (PCNL): does nephrostomy tube size matter? Results from the Global PCNL Study from the Clinical Research Office Endourology Society. World J Urol 2013;31(6):1563–1568.
  • Referans33. Keoghane SR, Cetti RJ, Rogers AE, Walmsley BH. Blood transfusion, embolization and nephrectomy after percutaneous nephrolithotomy (PCNL). BJU Int 2013; 111:628–632.
  • Referans34. Richstone L, Reggio E, Ost MC, et al. First prize (tie): hemorrhage following percutaneous renal surgery: characterization of angiographic findings. J Endourol 2008; 22:1129–1135.
  • Referans35. Kyriazis I, Panagopoulos V, Kallidonis P, et al. Complications in percutaneous nephrolithotomy. World J Urol 2015; 33:1069–1077.
  • Referans36. Kallidonis P, Panagopoulos V, Kyriazis I, Liatsikos E. Complications of percutaneous nephrolithotomy: classification, management, and prevention. Curr Opin Urol. 2016 Jan;26(1):88 94. doi: 10.1097/MOU.0000000000000232.
  • Referans37. Munver R, Delvecchio FC, Newman GE, Preminger GM. Critical analysis of supracostal access for percutaneous renal surgery. J Urol 2001; 166:1242– 1246.
  • Referans38. Lee WJ, Smith AD, Cubelli V, Badlani GH, Lewin B, Vernace F et al. Complications of percutaneous nephrolithotomy. Am J Roentgenol 1987;148(1):177–180.
  • Referans39. Traxer O. Management of injury to the bowel during percutaneous stone removal. J Endourol 2009; 23:1777–1780.
  • Referans40. Gerspach JM, Bellman GC, Stoller ML, Fugelso P. Conservative management of colon injury following percutaneous renal surgery. Urology1997;49(6):831–836.
  • Referans41. Seitz C, Desai M, Hacker A, et al. Incidence, prevention, and management of complications following percutaneous nephrolitholapaxy. Eur Urol 2012; 61:146–158.
  • Referans42. Culkin DJ, Wheeler JS Jr, Canning JR. Nephro-duodenal fistula: a complication of percutaneous nephrolithotomy. J Urol 1985; 134(3): 528–530.
  • Referans43. Hopper KD, Yakes WF. The posterior intercostal approach for percutaneous renal procedures: risk of puncturing the lung, spleen, and liver as determined by CT. Am J Roentgenol 1990; 154(1): 115–117.
  • Referans44. Ozturk H. Gastrointestinal system complications in percutaneous nephrolithotomy: a systematic review. J Endourol 2014; 28(11): 1256–1267.
  • Referans45. Fisher MB, Bianco FJJr, Carlin AM, Triest JA. Biliary peritonitis complicating percutaneous nephrolithomy requiring laparoscopic cholecystectomy. J Urol 2004;171(2 Pt 1):791–792.
  • Referans46. Mousavi-Bahar SH, Mehrabi S, Moslemi MK. Percutaneous nephrolithotomy complications in 671 consecutive patients: a single-center experience. Urol J 2011; 8:271–276.
  • Referans47. Paonessa JE, Gnessin E, Bhojani N, Williams JC Jr, Lingeman JE. Preoperative Bladder Urine Culture as a Predict or of Intraoperative Stone Culture Results: Clinical Implications and Relationship to Stone Composition. J Urol.2016 Sep;196(3):769-74. doi: 10.1016/j.juro.2016.03.148. Epub 2016 Mar 30.
  • Referans48. Yang MG, Zheng ZD, Xu ZQ, et al. Prophylaticantibioticuse in percutaneousnephrolithotomy: a meta-analysis. ZhonghuaWai Ke ZaZhi 2013; 51:922–927.
  • Referans49. Michel MS, Trojan L, Rassweiler JJ. Complications in percutaneous nephrolithotomy. Eur Urol 2007; 51:899–906.
  • Referans50. Morris DS, Wei JT, Taub DA, Dunn RL, Wolf JS Jr, Hollenbeck BK. Temporal trends in the use of percutaneous nephrolithotomy. J Urol 2006;175(5):1731–1736.
  • Referans51. Kamphuis GM, Baard J, Westendarp M, de la Rosette JJ. Lessons learned from the CROES percutaneous nephrolithotomy global study. World J Urol 2015; 33(2): 223–233.

Perkutan Nefrolitotomide Komplikasyonlar ve Yaklaşım

Yıl 2019, Cilt: 2 Sayı: 2, 107 - 117, 31.08.2019

Mutlu Deger İbrahim Atilla Arıdogan

Öz

Böbrek taşı hastalığı dünyada oldukça yaygın görülen bir hastalıktır. İki cm’den daha büyük böbrek taşlarında altın standart cerrahi yöntem Perkütan nefrolitotomi (PNL) işlemi olmasına rağmen bu işlemin %20’den %83'e varan komplikasyon oranları bildirilmiştir. PNL işleminin kanama, sepsis, toplayıcı sistem yaralanması, kolon, ince bağırsak, toraks, karaciğer, safra kesesi ve dalak gibi komşu organ yaralanması ve ölüm gibi oldukça çeşitli yelpazede komplikasyonları mevcuttur. Uygun hasta ve preoperatif iyi değerlendirmelerle bu komplikasyonların oranları düşürülebilir. Deneyim arttıkça komplikasyon oranı azalmaktadır. En önemlisi komplikasyonu erken tanımlayabilmektir. Major komplikasyonlar konservatif ve minimal invaziv yöntemlerle çözülebilmektedir.

Biz bu derlememizde PNL işleminin komplikasyonlarını ve bu komplikasyonlara yaklaşımı ele aldık.

Anahtar Kelimeler

Böbrek Böbrek Taşı Perkütan Nefrolitotomi Komplikasyon

Kaynakça

  • Referans1. Sorokin I, Mamoulakis C, Miyazawa K, Rodgers A, Talati J, Lotan Y. Epidemiology of stone disease across the World. World J Urol. 2017 Sep;35(9):1301-1320. doi: 10.1007/s00345-017-2008-6.
  • Referans2. Ogg CS, Saxton HM, Cameron JS. Percutaneous needle nephrostomy. Br Med J. 1969; 4:657-60.
  • Referans3. Alken P, Hutschenreiter G, Guenther R. Percutaneous kidney stone removal. EurUrol. 1982; 8:304–11.
  • Referans4. Hafron J, Fogarty JD, Boczko D, Hoenig DM. Combined ureterorenoscopy and shock wave lithotripsy for large renal stone burden: an alternative to percutaneous nephrolithotomy? J Endourol 2005; 19:464–8.
  • Referans5. Marguet CG, Springhart WP, Tan YH, et al. Simultaneous combined use of flexible ureteroscopy and percutaneous nephrolithotomy to reduce the number of access tracts in the management of complex renal calculi. BJU Int 2005; 96:1097–100.
  • Referans6. Türk C, Knoll T, Petrik A et al. European association of urology, guidelines on urolithiasis. Eur Urol 2015; 69:468.
  • Referans7. Taylor E, Miller J, Chi T, Stoller ML. Complications associated with percutaneous nephrolithotomy. Transl Androl Urol. 2012 Dec; 1(4):223-8. doi: 10.3978/j.issn.2223-4683.2012.12.01.
  • Referans8. Michel MS, Trojan L, Rassweiler JJ. Complications in Percutaneous Nephrolithotomy. Eur Urol. 2007 Apr;51(4):899-906; discussion 906. Epub 2006 Oct 25. Review.
  • Referans9. 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; 25:11-7.
  • Referans10. Shin TS, Cho HJ, Hong SH, et al. Complications of Percutaneous Nephrolithotomy Classified by the Modified Clavien Grading System: A Single Center’s Experienceover 16 Years. Korean J Urol 2011; 52:769-75.
  • Referans11. Skolarikos A, de la Rosette J. Prevention and treatment of complications following percutaneous nephrolithotomy. Curr Opin Urol 2008; 18: 229-34.
  • Referans12. Tonolini M, Villa F, Ippolito S, et al. Cross-sectional imaging of iatrogenic complications after extracorporeal and endourological treatment of urolithiasis. Insights Imaging 2014; 5:677–689.
  • Referans13. Clayman RV, Surya V, Hunter D, Castaneda-Zuniga WR, Miller RP, Coleman C et al. Renal vascular complications associated with the percutaneous removal of renal calculi. J Urol 1984;132(2):228–230.
  • Referans14. Lang EK. Percutaneous nephrostolithotomy and lithotripsy: a multi-institutionalsurvey of complications. Radiology1987;162(1 Pt 1):25–30.
  • Referans15. Roth RA, Beckmann CF. Complications of extracorporeal shock-wave lithotripsy and percutaneous nephrolithotomy. Urol Clin N Am1988;15(2):155–166.
  • Referans16. Srivastava A, Singh KJ, Suri A, Dubey D, Kumar A, Kapoor R et al. Vascular complications after percutaneous nephrolithotomy: are there any predictive factors? Urology 2005 66(1):38–40.
  • Referans17. Stoller ML, Wolf JS Jr, StLezin MA. Estimated blood loss and transfusion rates associated with percutaneous nephrolithotomy. J Urol 1994; 152(6 Pt 1):1977–1981.
  • Referans18. El-Nahas AR, Shokeir AA, El-Assmy AM, Mohsen T, Shoma AM, Eraky I et al. Post percutaneous nephrolithotomy extensive hemorrhage: a study of risk factors. J Urol 2007;177(2):576–579.
  • Referans19. Kukreja R, Desai M, Patel S, Bapat S, Desai M. Factors affecting blood loss during percutaneous nephrolithotomy: prospective study. J Endourol 2004;18(8):715–722.
  • Referans20. Said SH, Al Kadum Hassan MA, Ali RH, Aghaways I, Kakamad FH, Mohammad KQ. Percutaneous nephrolithotomy; alarming variables for postoperative bleeding. Arab J Urol2017;15(1):24–29.
  • Referans21. Turna B, Nazli O, Demiryoguran S, Mammadov R, Cal C. Percutaneous nephrolithotomy: variables that influence hemorrhage. Urology 2007;69(4):603–607.
  • Referans22. Assimos D, Krambeck A, Miller NL, Monga M, Murad MH, Nelson CP et al. Surgical management of stones: American Urological Association/Endourological Society Guideline, PART I. J Urol 2016;196(4):1153–1160.
  • Referans23. Leavitt DA, Theckumparampil N, Moreira DM, Elsamra SE, Waingankar N, Hoenig DM et al. Continuing aspirin therapy during percutaneous nephrolithotomy: unsafe or underutilized? J Endourol 2014;28(12):1399–1403.
  • Referans24. Culkin DJ, Exaire EJ, Green D, Soloway MS, Gross AJ, Desai MR et al. Anticoagulation and antiplatelet therapy in urological practice: ICUD/AUA review paper. J Urol2014;192(4):1026–1034.
  • Referans25. Mahaffey KG, Bolton DM, Stoller ML. Urologist directed percutaneous nephrostomy tube placement. J Urol 1994;152(6 Pt 1):1973–1976.
  • Referans26. Davidoff R, Bellman GC. Influence of technique of percutaneous tract creation on incidence of renal hemorrhage. J Urol. 1997; 157(4):1229–1231.
  • Referans27. Yamaguchi A, Skolarikos A, Buchholz NP, Chomon GB, Grasso M, Saba P et al. Operating times and bleeding complications in percutaneous nephrolithotomy: a comparison of tract dilation methods in 5537 patients in the Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study. J Endourol. 2011; 25(6):933–939.
  • Referans28. Li Y, Yang L, Xu P, Shen P, Qian S, Wei W et al. One-shot versus gradual dilation technique for tract creation in percutaneous nephrolithotomy: a systematic review and meta-analysis. Urolithiasis. 2013;41(5):443–448.
  • Referans29. Srivastava A, Singh S, Dhayal IR, Rai P.A prospective randomized study comparing the four tract dilation methods of percutaneous nephrolithotomy. World J Urol. 2017;35(5):803–807.
  • Referans30. Karakose A, Aydogdu O, Atesci YZ. Does the use of smaller Amplatz sheath size reduce complication rates in percutaneous nephrolithotomy? Urol J. 2014;11(4):1752–1756.
  • Referans31. Wollin DA, Preminger GM. Percutaneous nephrolithotomy: complications and how to deal with them. Urolithiasis. 2018 Feb;46(1):87-97. doi: 10.1007/s00240-017-1022-x. Epub 2017 Nov 17. Review.
  • Referans32. Cormio L, Preminger G, Saussine C, Buchholz NP, Zhang X, Walfridsson H et al. Nephrostomy in percutaneous nephrolithotomy (PCNL): does nephrostomy tube size matter? Results from the Global PCNL Study from the Clinical Research Office Endourology Society. World J Urol 2013;31(6):1563–1568.
  • Referans33. Keoghane SR, Cetti RJ, Rogers AE, Walmsley BH. Blood transfusion, embolization and nephrectomy after percutaneous nephrolithotomy (PCNL). BJU Int 2013; 111:628–632.
  • Referans34. Richstone L, Reggio E, Ost MC, et al. First prize (tie): hemorrhage following percutaneous renal surgery: characterization of angiographic findings. J Endourol 2008; 22:1129–1135.
  • Referans35. Kyriazis I, Panagopoulos V, Kallidonis P, et al. Complications in percutaneous nephrolithotomy. World J Urol 2015; 33:1069–1077.
  • Referans36. Kallidonis P, Panagopoulos V, Kyriazis I, Liatsikos E. Complications of percutaneous nephrolithotomy: classification, management, and prevention. Curr Opin Urol. 2016 Jan;26(1):88 94. doi: 10.1097/MOU.0000000000000232.
  • Referans37. Munver R, Delvecchio FC, Newman GE, Preminger GM. Critical analysis of supracostal access for percutaneous renal surgery. J Urol 2001; 166:1242– 1246.
  • Referans38. Lee WJ, Smith AD, Cubelli V, Badlani GH, Lewin B, Vernace F et al. Complications of percutaneous nephrolithotomy. Am J Roentgenol 1987;148(1):177–180.
  • Referans39. Traxer O. Management of injury to the bowel during percutaneous stone removal. J Endourol 2009; 23:1777–1780.
  • Referans40. Gerspach JM, Bellman GC, Stoller ML, Fugelso P. Conservative management of colon injury following percutaneous renal surgery. Urology1997;49(6):831–836.
  • Referans41. Seitz C, Desai M, Hacker A, et al. Incidence, prevention, and management of complications following percutaneous nephrolitholapaxy. Eur Urol 2012; 61:146–158.
  • Referans42. Culkin DJ, Wheeler JS Jr, Canning JR. Nephro-duodenal fistula: a complication of percutaneous nephrolithotomy. J Urol 1985; 134(3): 528–530.
  • Referans43. Hopper KD, Yakes WF. The posterior intercostal approach for percutaneous renal procedures: risk of puncturing the lung, spleen, and liver as determined by CT. Am J Roentgenol 1990; 154(1): 115–117.
  • Referans44. Ozturk H. Gastrointestinal system complications in percutaneous nephrolithotomy: a systematic review. J Endourol 2014; 28(11): 1256–1267.
  • Referans45. Fisher MB, Bianco FJJr, Carlin AM, Triest JA. Biliary peritonitis complicating percutaneous nephrolithomy requiring laparoscopic cholecystectomy. J Urol 2004;171(2 Pt 1):791–792.
  • Referans46. Mousavi-Bahar SH, Mehrabi S, Moslemi MK. Percutaneous nephrolithotomy complications in 671 consecutive patients: a single-center experience. Urol J 2011; 8:271–276.
  • Referans47. Paonessa JE, Gnessin E, Bhojani N, Williams JC Jr, Lingeman JE. Preoperative Bladder Urine Culture as a Predict or of Intraoperative Stone Culture Results: Clinical Implications and Relationship to Stone Composition. J Urol.2016 Sep;196(3):769-74. doi: 10.1016/j.juro.2016.03.148. Epub 2016 Mar 30.
  • Referans48. Yang MG, Zheng ZD, Xu ZQ, et al. Prophylaticantibioticuse in percutaneousnephrolithotomy: a meta-analysis. ZhonghuaWai Ke ZaZhi 2013; 51:922–927.
  • Referans49. Michel MS, Trojan L, Rassweiler JJ. Complications in percutaneous nephrolithotomy. Eur Urol 2007; 51:899–906.
  • Referans50. Morris DS, Wei JT, Taub DA, Dunn RL, Wolf JS Jr, Hollenbeck BK. Temporal trends in the use of percutaneous nephrolithotomy. J Urol 2006;175(5):1731–1736.
  • Referans51. Kamphuis GM, Baard J, Westendarp M, de la Rosette JJ. Lessons learned from the CROES percutaneous nephrolithotomy global study. World J Urol 2015; 33(2): 223–233.
Toplam 51 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Anesteziyoloji
Bölüm Derlemeler
Yazarlar

Mutlu Deger 0000-0002-8357-5744

İbrahim Atilla Arıdogan Bu kişi benim

Yayımlanma Tarihi 31 Ağustos 2019
Kabul Tarihi 28 Ağustos 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 2 Sayı: 2

Kaynak Göster

APA Deger, M., & Arıdogan, İ. A. (2019). Perkutan Nefrolitotomide Komplikasyonlar ve Yaklaşım. Journal of Cukurova Anesthesia and Surgical Sciences, 2(2), 107-117.
 Kapak Resmi İndir
https://dergipark.org.tr/tr/download/journal-file/11303