PurposeAlthough percutaneous nephrolithotomy (PCNL) has been accepted as a standard method for the management of large renal stones, the incidence of renal hemorrhage is relatively high. This study investigated the variables that affect bleeding during PCNL.Materials and MethodsThe medical records of 370 patients who underwent PCNL by a single surgeon from January 2005 to December 2010 were reviewed retrospectively. All patients were divided into two groups according to median blood loss (lesser bleeding group and higher bleeding group). Various clinical and perioperative factors including age, sex, stone size and position, degree of hydronephrosis, operative time, underlying disease, history of anticoagulant medication, presence of previous nephrostomy catheter, stone composition, and thickness of the renal cortex were assessed. For statistical assessment, univariate and multivariate logistic regression analyses were used.ResultsThe mean patient age was 48.8 years (range, 22 to 75 years). Forty-three patients (11.6%) received a transfusion and 9 patients (2.4%) underwent angioembolization after surgery. The mean blood loss was 511.8±341.3 mL. Body mass index (BMI), stone size, stone position, operation time, and degree of preoperative hydronephrosis were predictive factors for severe bleeding during PCNL.ConclusionsOn the basis of the results achieved by a single surgeon, staghorn stones, high BMI, large stones, prolonged operation time, and absence of hydronephrosis were significantly associated with the risk of severe bleeding during PCNL.

Background/Aims: Newer operative link for gastritis assessment (OLGA) system tried to stage gastritis in view of gastric cancer (GC) risk and endoscopic atrophic border (EAB) was well correlated with OLGA. We described the gastritis on the base of EAB during endoscopic sessions and classified them into high or low stage gastritis as suggested by Quach et al. and analyzed them. Materials and Methods: A total of 158 subjects who visit our health promotion center were graded on the base of EAB by conventional endoscopy and reallocated according to ages. Linear-by-linear association was performed to identify the differences of gastritis among age-groups. Results: In our study 31% of patients had atrophic gastritis (AG) over AG closed type 3∼open type 1 compatible with OLGA stages III/IV (high stage gastritis). High and low stage gastritis showed significantly different distribution at each age group. The proportion of endoscopically diagnosed high stage gastritis increased in proportion to age. Contrast to Quach et al. our study showed prevalence of high stage gastritis under 40s, even in 20s or 30s (P=0.002). Conclusions: OLGA based EAB is easy and useful in GC risk stratification. In our study unlike the previous study of Quach et al., high stage gastritis was found in younger age groups. We should and could make an effort to prevent GC in even younger age groups with the aid of EAB. Additionally we could get organized and communicable stratified data about GC risk.