EFFICACY AND COMPLICATIONS OF PERCUTANEOUS NEPHROLITHOTRIPSY IN THE TREATMENT OF PATIENTS WITH UROLITHIASIS UNDERGOING ANTICOAGULANT AND ANTIPLATELET THERAPY
DOI:
https://doi.org/10.32689/2663-0672-2025-1-3Keywords:
percutaneous nephrolithotripsy, urolithiasis, anticoagulant therapy, antiplatelet therapy, hematuria, complications, Clavien-Dindo, Stone-free rateAbstract
Urolithiasis is a common urological pathology that often requires surgical intervention. A special group includes patients on anticoagulant and antiplatelet therapy, as surgical treatment in such patients is associated with an increased risk of bleeding. The aim of the study was to compare the efficacy and safety of percutaneous nephrolithotripsy (PNLT) in patients with urolithiasis (UTI) receiving anticoagulant and antiplatelet therapy and in patients without such therapy. Materials and Methods: A retrospective analysis of the results of the treatment of 150 patients who underwent PNLT for renal calculi was performed. Patients were divided into two groups: Group IIa (n=72) - patients who received anticoagulant or antiplatelet therapy, and Group IIb (n=78) - patients without such therapy. We evaluated the duration of hematuria, duration of nephrostomy and urethral catheter placement, duration of hospitalization, intraoperative visualization, complication rate according to the Clavien-Dindo classification, and complete stone removal rate (SFR). Results: patients in group IIa had a significantly longer duration of hematuria, longer retention of the nephrostomy and urethral catheter, and a longer hospital stay. Intraoperative visualization was worse in group IIa. The incidence of complications in group IIa was higher, mainly due to complications of category I-II according to the Clavien-Dindo classification. SFR did not have a statistically significant difference between the groups. Conclusions: LNLT is an effective method of treating urolithiasis in patients receiving anticoagulant and antiplatelet therapy, with an SFR rate comparable to the results of treatment of patients without such therapy. However, this category of patients has a longer duration of hematuria, longer drainage and hospitalization, more frequent complications, and poorer intraoperative visualization, which requires modification of preoperative preparation and postoperative management.
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