ABSTRACT
Objective To evaluate the efficacy and safety of management of kidney calculi in non-uronephrosis by percutaneous nephrolithotripsy (PCNL) under ultrasound guidance. Methods From July 2005 to June 2008, 97 cases of kidney calculi in non-uronephrosis were performed by percutaneous nephrolithotripsy. A tube was first inserted into the pelvis through cystoscope, and saline was instilled to dilate collecting system. Antegrade percutaneous access was obtained under ultrasound guidance. A combination of pneumatic and ultrasonic lithotrite was used to disintegrate and remove stone under direct vision. Clinical data including operation time, complications and stone free rate were analyzed retrospectively. Results The perutaneous renal access was successfully established under ultrasound guidance in all patients, immediate phase Ⅰ lithotripsy was performed in 95 cases and delayed phase Ⅱ lithotripsy in 2 cases. Operation time was 70-180 min, average time was (96±23 ) min. The average blood loss was 60 ml (20-500 ml), 4 cases had transfusion during the PCNL and average 400 ml. Minor pyrexia ( < 39℃) was seen in 24 cases,whereas serious pyrexia was noted in 3 cases. Conservatively administered with appropriate antibiotics, the fever disapeared in 27 cases within 5 days postoperatively. Severe complications did not occur during nephrolithotripsy. Stones were cleared completely in 78 out of 97 cases (80.4%)during immediate phase Ⅰ lithotripsy, residual stone fragment was found in 19 cases. Conclusion The management of kidney calculi in non-uronephrosis by PCNL appears to be efficacious and safe under ultrasound guidance.
ABSTRACT
Objective To study the effect of fish oil on calcium oxalate kidney stone formation. Methods The efficacy of unprocessed fish oil in the treatment of 20 hypercakiuric patients with urinary stones was evaluated, after administration of fish oil at dosage of 3000mg daioy of one week. Results Excretion of urinary calcium reduced significantly from (461.37?80.67)mg/d to (312.63?40.57)mg/d.The Mg2+ reduced from (136. 41?56. 12) mg/d to (108.43?18.96) mg/d. The Mg2+ /Ca2+ increased significantly from (0.29?0.08) to ( 0. 36?0.11)-Uric acid remained unchanged. Conclusion Unprocessed fish oil is safe and effective for the reduction of urinary calcium and might be used for the prevention of calcium stone recurrence.
ABSTRACT
Objective To improve the diagnosis and tr ea tment level of reno-colic fistula. Methods The clinical data of 6 patients (4 males and 2 females,average age of 37 years) with reno-c olic fistula were analyzed retrospectively.Among them,4 cases had the fistula on the right side and 2,on the left.On etiology,3 cases had nephrolithiasis compli cated with infection;1,nephrolithiasis accompanied by carcinoma of renal pelvis; 1, tuberculosis of kidney; 1,perinephric abscess.There were no typical clinical symptoms in the 6 patients and they underwent retrograde pyelography or antegrad e pyelography for confirmation of diagnosis. Results Sur gical management was carried out in the 6 patients.Among them,1 case underwent n ephrectomy,colectomy and colocolostomy;2,nephrectomy,fistulectomy and repair of the colon;2,pyelolithotomy or ureterolithotomy,fistulectomy and repair of the ki dney and colon;1 case of nephrolithiasis with carcinoma of renal pelvis underwen t exploratory laparotomy and tumor biopsy with no surgery due to severe adhesion of the kidney and colon with the peripheral tissues.Five patients were followed up for 8 months to 9 years (mean,46 months) postoperatively;no surgical complic ation occurred and they had a satisfactory recovery.Only 1 case died of metastas is of tumor 6 months postoperatively. Conclusions Nephro lithiasis complicated with infection is a major cause of reno-colic fistula.Ret rograde pyelography or antegrade pyelography is the most reliable method in the diagnosis of reno-colic fistula.As soon as the diagnosis is made, surgical trea tment should be performed.