In situ big dissection of anatrophic nephrolithotomy to remove large renal staghorn calculi:report of 52 cases / 中国医师进修杂志

Objective To discuss the method and effect of large renal staghorn calculi by anatrophic nephrolithotomy (AN).Methods Fifty-two patients with large renal staghom calculi underwent AN.Bilateral renal calculi disease was present in 3 patients,so that a number of 55 procedures were operated.Preoperative evaluation included urinalysis,urine culture,renal function,and ultragound,CT,KUB and IVU.A flank incision was between the 11th and 12th ribs and the kidney was freed.After interrupted renal pedicle in situ hypothermia,the renal parenchyma incision was made along the avascular plane which is outside in the back of the kidney.The collecting system was opened.The calculi were removed.The collecting system was reconstructed.The renal parenchyma was closed and the renal circulation was reestablished.The protected management of renal function was made intraoperative.Postoperative follow-up consisted of urinalysis,renal function,ultrasound,KUB,IVU and ECT.Results The operative time was (117±45) minutes.The renal ischemia time WaS (29±15)minutes.Five cases underwent blood transfusion.Mean amount of blood transfusion was 230 ml.Four cases had remained calculi.The stone-free rate was 92.3%.No recent complication occurred after operation.Postoperative follow-up indicated that renal function was normal.Conclusions AN is the most appropriate method for patients with large renal staghorn calculi because of the highest stone-free rate,the lowest stone-recurred rate and a safe and effective operative procedure with less complication.Renal function damages just little through a series of protected management.Nephrectomy is avoided to part of patients.

Management and investigation of testicular torsion / 中华男科学杂志

<p><b>OBJECTIVE</b>To improve the diagnosis and treatment of testicular torsion.</p><p><b>METHODS</b>The clinical data of 9 cases of suspected testicular torsion were restrospectively analyzed to summarize the diagnostic experiences.</p><p><b>RESULTS</b>The 9 patients were 12-27 (mean 15) years old, 8 treated by surgery and 1 by spontaneous detorsion under anesthesia. Among them, 7 cases were proved to be testicular torsion and 1 case was acute epididymitis. Of the 7 cases of testicular torsion, 6 were found to have 180-720-degree torsion around the spermatic cord and 1 case 180-degree around the verticality of the spermatic cord. The accuracy rate of color ultrasonic examination was 87.5%.</p><p><b>CONCLUSION</b>Patients with acute scrotum pain should have color ultrasonic examination. Not all cases of the disease had testicular torsion around the spermatic cord. Emergency operation should be performed on any suspected case of testicular torsion.</p>