From the Research
Intraoperative complications during PC Rent can be effectively managed with the administration of tranexamic acid, which has been shown to significantly decrease the incidence of postoperative bleeding without increasing the risk of venous thromboembolism, as demonstrated in a recent study published in 2024 1. Intraoperative complications during PC Rent require immediate recognition and management.
- If a collecting system perforation occurs, the procedure should be terminated immediately and a nephrostomy tube should be placed to ensure adequate drainage.
- For small perforations, conservative management with nephrostomy drainage for 48-72 hours is usually sufficient.
- For larger perforations or if there is significant bleeding, placement of a double-J ureteral stent alongside the nephrostomy tube is recommended to ensure both antegrade and retrograde drainage.
- Antibiotics should be continued, typically with a fluoroquinolone like ciprofloxacin 500mg twice daily or a cephalosporin like ceftriaxone 1g daily for 5-7 days.
- Close monitoring for signs of urosepsis, including fever, tachycardia, and hypotension is essential.
- Bleeding complications should be managed with nephrostomy tube clamping to tamponade the bleeding site, and angioembolization may be necessary for persistent hemorrhage. The use of tranexamic acid has been shown to be effective in reducing intraoperative bleeding in various surgical procedures, including middle ear surgery 2 and laparoscopic sleeve gastrectomy 1. However, it is essential to note that the optimal dose, timing, and route of administration of tranexamic acid remain unclear, and its use should be tailored to the individual patient's needs and risk factors 3. In addition, the potential risks and benefits of tranexamic acid administration should be carefully considered, particularly in patients with a high risk of stroke or other thromboembolic events 4.