Study of Laparoscopic Management of Urological Diseases at Tertiary Care Centre

Introduction: With the advent of laparoscopic surgery,urologists once again found it necessary to traverse theperitoneal cavity in order to provide their patients with thebenefit of this less invasive type of surgery. In this study westudied the prevalence of laparoscopic urological surgeries,ergonomics involved, difficulties faced and complicationsrelated to laparoscopic procedures.Material and methods: It was a prospective hospitalbased non-randomised study carried out among 36 indoorcases operated using various laparoscopic procedures vizlaparoscopic pyeloplasty, laparoscopic pyelolithotomy,laparoscopic nephrectomy, laparoscopic ureterolithotomy etc.admitted under department of general surgery in a tertiaryhealthcare teaching instituteResults: In the present study, out of 31 cases, 20 casespresented with diagnosis of renal stone disease (Renal pelviccalculi, staghorn renal calculi and ureteric calculi). Total 5cases i.e 16.12% cases were having diagnosis of chronic nonfunctioning kidney while 3 cases (9.67%) were presented withrenal cell carcinoma. 3 cases (9.67%) presented with pelviureteric junction obstruction.Conclusion: Laparoscopic pyelolithotomy in extrarenal pelvisis a good procedure as pelvis can be reached easily especiallyif pelvis is dilated and Laparoscopic ureterolithotomy inabdominal ureter is a promising surgery as entire ureter canbe visualized so stones are easily detected and surgeon has abetter control of proximal ureter in case of slippage of calculas

Comparative Study of Clonidine Vs Dexmedetomidine for Hemodynamic Stability and Postoperative Analgesia during Laproscopic Surgery

Introduction: Alpha-2 (α2) adrenergic receptor agonists,clonidine and dexmedetomidine, are widely used as adjuvantsduring anesthesia for analgesic, sedative, sympatholytic, andcardiovascular stabilizing effects. The aim of this study was todifferentiate the effectiveness of intravenously administeredclonidine and dexmedetomidine for hemodynamic stabilityand postoperative analgesia during laparoscopic surgery.Materials and methods: This was a randomised, double blindand prospective study in which Group 1 included patients whoreceived 2 µg/kg of clonidine dilute in 10 ml normal saline,given slow intravenous infusion over 10 minutes beforeinduction of general anaesthesia. Group 2 patients received 1µg/kg of dexmedetomidine diluted in 10 ml of normal saline,given slowly intravenous infusion over 10 minutes beforeinduction of general anaesthesia.Results: The data was presented as Mean ± SD. Groups werecompared by independent student’s t test. Groups were alsocompared by repeated measure analysis of variance (ANOVA)using general linear models (GLM). The mean scores of SBPwere higher in group 1 among both the groups over the periods.The mean scores of DBP in both groups was similar over theperiods with slightly being higher in Group 1 especially after30 min to till end (Extubation) as compared to Group 2.Conclusion: It can be concluded that α 2 agonists were foundto be effective in attenuating the hemodynamic responseto pneumoperitoneum during laparoscopic surgeries andprovides reliable postoperative analgesia and sedation whenused as a premedication agent

The comparison of robot-assisted laparoscopic and open pyelolithotomy in the management of nonstaghorn renal calculi larger than 2 cm / 复旦学报（医学版）

Objective To investigate the feasibility and safety of robot-assisted laparoscopic pyelolithotomy (RALPL) as the surgical management for nonstaghorn renal calculi larger than 2 cm. Methods Among the patients admitted to our hospital for nonstaghorn renal calculi larger than 2 cm between Jun. ,2013 and Jun. ,2017, a retrospective analysis was performed on the treatment outcome of patients undergoing RALPL (48 cases) and open pyelolithotomy (OPL) (44 cases). The initial stone-free rate, mean operating time, hemoglobin drop, off-bed activity time and hospital stay were compared between two groups. Results Compared with OPL group, RALPL group had a higher initial stone-free rate (91. 66% vs. 70.45%, P < 0.05), and had significant lesser hemoglobin drop, shorter operating time, off-bed activity time and hospital stay. There was no ClavienⅡ or above complications in RALPL group, but there were 2 cases of ClavienⅡcomplications in OPL group. Conclusions Transperitoneal approach RALPL has a better visual angle to observe renal pelvis and calyces, and can ensure a higher initial stone-free rate under the conditions of low intrarenal pelvic pressure and leaving renal parenchyma and vessels intact. RALPL is a minimally invasive, effective and safe treatment, and is an alternative indication for renal calculi larger than 2 cm (including renal pelvis stones with accompanying renal calyceal stones).

Laparoscopic management of urinary tract calculi: uncommon but effective alternative to open surgery in certain situations

Introduction: The use of minimally invasive techniques has helped decrease the morbidity and convalescence associated with the management of urolithiasis. In this regard laparoscopy has also developed as one of the modalities. However, in comparison with other surgeries, laparoscopy for stone removal is relatively uncommon. Here we present our experience of laparoscopic stone surgeries. Materials and methods: 10 patients with large renal and ureteric calculi where planned for laparoscopic surgery. Three patients had 2-3 cm proximal ureteric calculi, 2 patients had > 3cm renal pelvic calculi, 2 patients had multiple renal calculi associated with PUJ Obstruction, 2 patients had pelvic calculi in ectopic kidneys and one patient had calculus in crossed fused ectopia. Results: All the patients had a smooth intra-operative course. Post-operative period was uneventful except for one patient with crossed fused ectopia. One of the patients with PUJ obstruction had a single residual calculus which was managed with ESWL on follow up. Conclusions: Laparoscopic approach can be an effective alternative to endourological or open procedures for stone removal. It can be utilized for stone management in urinary tract where ESWL, PCNL and ureteroscopy have failed or deemed unsuitable. It is also a good option in patients with unusual anatomy such as ectopic kidney.

Comparison of the effect between percutaneous nephrolithotomy and retroperitoneal laparoscopic pyelolithotomy in the treatment of renal pelvis calculus / 新乡医学院学报

Objective To compare the clinical effect between percutaneous nephrolithotomy (PCNL) and retroperitoneal laparoscopic pyelolithotomy (RLP) in the treatment of renal pelvis calculus,so as to provide evidence for the treatment of renal pelvis calculus.Methods A total of 108 patients with renal pelvis calculus were selected from January 2012 to December 2016 in Zhumadian Central Hospital.The patients were divided into PCNL group (n =59) and RLP group (n =49) according to the therapeutic method.The operation time,intraoperative blood loss,intraoperative blood transfusion rate,operative success rate,stone clearance rate,postoperative hemoglobin reduction,postoperative analgesia time,postoperative hospitalization time and the incidence of complications were compared between the two groups.Results The success rate of operation in PC-NL group and RLP group was 94.9％ (56/59) and 100.0％ (49/49) respectively,there was no significant difference in the success rate of operation between the two groups (x2 =1.026,P ＞ 0.05).The stone clearance rate in PCNL group and RLP group was 94.9％ (56/59) and 98.0％ (48/49) respectively,there was no significant difference in the stone clearance rate between the two groups (x2 =0.140,P ＞ 0.05).The intraoperative blood transfusion rate in PCNL group and RLP group was 5.1％ (3/59) and 2.0％ (1/49) respectively,there was no significant difference in the intraoperative blood transfusion rate between the two groups (x2 =0.105,P ＞ 0.05).There was no significant difference in operation time and postoperative analgesia time between the two groups (P ＞ 0.05).Compared with the PCNL group,the blood loss and postoperative hemoglobin reduction were less,and the postoperative hospitalization time was shorter in the RLP group (P ＜ 0.05).The incidence of postoperative urinary leakage,urinary tract infection and secondary hemorrhage in PCNL group was 3.4％ (2/59),8.5％ (5/59)and 6.8％ (4/59) respectively;the incidence of postoperative urinary leakage,urinary tract infection and secondary hemorrhage in RLP group was 8.2％ (4/49),4.1％ (2/49) and 4.1％ (2/49) respectively;there was no significant difference in the incidence of postoperative urinary leakage,urinary tract infection and secondary hemorrhage between the two groups (x2 =2.975,1.064,1.811;P ＞ 0.05).Conclusion The clinical effect of PCNL and RLP in the treatment of renal pelvis calculus is fairly,and their safety is high.However,RLP has the advantages of less intraoperative bleeding,quick postoperative recovery and short hospitalization time.

Which Is the Better Therapy for Solitary Renal Pelvic Stone,Retroperitoneal Laparoscopic Intrasinusal Pyelolithotomy or Percutaneous Nephrolithotomy / 中山大学学报(医学科学版)

Objective]To compare the efficacy and safety of retroperitoneal laparoscopic intrasinusal pyelolithotomy (RLIP) and percutaneous nephrolithotomy(PCNL)in the treatment of solitary renal pelvic stone.[Methods]From March 2012 to September 2016,101 patients with solitary renal pelvic stone,divided into RLIP group(n=46)and PCNL group(n=55),were retrospectively analyzed to compare the difference between the two groups in clinical curative effect.[Results]There was no difference between the two groups regarding age,sex,stone side and stone size. Although the operative time was significantly longer,the stone-free rate in the RLIP group was significantly higher than that in the PCNL(P 38.5℃)and the decrease values of hemoglobin and glomerular filtration rate.[Conclusion]Compared to PCNL,RLIP was more efficient and slight safer in the management of solitary renal pelvic stone ,and had a certain value for generalization in clinic.

The comparative study of retroperitoneal laparoscopic pyelolithotomy and percutaneous nephrolithotomy in treating renal pelvic stone / 中华泌尿外科杂志

Objective To evaluate the efficacy of the retroperitoneal laparoscopic pyelolithotomy (RLP) and the percutaneous nephrolithotomy (PCNL) in treating renal pelvic stone.Methods The data of 89 patients diagnosed as renal pelvic stone were retrospectively reviewed from January 2009 to July 2016,of whom 43 patients underwent RLP and 46 underwent PCNL.Statistical analysis was performed regarding operation time,blood loss,mean hospital stay,complication rate,and stone-free rate.Results The operation time in RLP group and PCNL group was (117.5 ± 16.7) min and (118.3 ± 16.6) min,respectively,and there was no significant difference (P =0.547).For the two groups,the mean hospital stay was (4.5 ± 0.5) d and (6.1 ± 0.9) d,the mean hemoglobin decrease was (4.5 ± 1.2) g/L and (18.1 ± 3.4) g/L,the post-operative blood transfusion rate was 2.3％ and 14.0％,the post-operative septic shock rate was 0 and 9.3％,respectively,with significant difference between the two groups (P ＜ 0.05).The stone-free rate in both groups was 97.7％ and 95.3％ with no significant difference (P =0.557).Conclusions RLP has the advantages of quick recovery,less blood loss and lower complication rate than PCNL.It could be a minimally invasive option for the treatment of renal pelvic stone.

Retroperitoneal laparoscopic pyelolithotomy combined with holmium laser lithotripsy under flexible cystoscopy in treatment of complicated nephrolithiasis / 局解手术学杂志

Objective To evaluate the efficacy and safety of retroperitoneal laparoscopic pyelolithotomy ( RLP) combined with holmium laser lithotripsy under flexible cystoscopy in the treatment of complicated nephrolithiasis. Methods The retrospective analysis was made on the clinical data of 37 patients who underwent RLP and holmium laser lithotripsy under flexible cystoscopy for complicated nephrolithiasis from January 2013 to January 2014. The clinic parameters involved basic data of patients,operational time,blood loss,post-operative hospital stay,the status of stone-free,perioperative complications,and the follow-up data of patients were observed. Results No patient was converted to open surgery. The mean stone size was (2. 8 ± 0. 9) cm in diameter,operational time was (89 ± 24) min,blood loss was (21. 3 ± 7. 7) mL,post-operative hospital stay was (6. 8 ± 1. 7) d,the stone removal rate in one session was 94. 6%. One case occurred urinary leakage,1 case occurred fever after operation,who were all recovered through conservative treatment. All cases were followed up at the sixth months after operation. Conclusion RLP combined with holmium laser lithotripsy under flexible cystoscopy is effective and safe for the treatment of com-plicated nephrolithiasis.

Extravasación urinaria renal espontánea / Spontaneous renal urinary extravasation

La extravasación espontánea de orina, descrita por Albarrán y publicada por Sole se consideraba como un hallazgo radiológico poco frecuente y la definió en 198 como la salida de orina fuera del tracto urinario en ausencia de trauma, de intervención quirúrgica previa o reciente y tampoco sin antecedente de instrumentación urológica o de urografía excretora practicada con compresión externa. Se presenta a un paciente de 28 años, sin antecedentes de interés, que acudió con cuadro astenia de 1 mes de evolución, asociado a dolor en fosa lumbar izquierda. Que fue estudiado mediante ecografía y tomografía computarizada (TC). Las exploraciones radiológicas identificaron múltiples litiasis en uréter proximal y distal izquierdo. Voluminosa colección de baja densidad rodeando al riñón izquierdo, limitada por la fascia pararrenal sugestiva de urinoma, identificando solución de continuidad en cáliz superior, que se comunica con el urinoma. El tratamiento inicial del paciente fue la colocación de Nefrostomía percutánea de urgencia, para realizar posteriormente, ureteroscopia con ascensión de las litiasis y extracción de estas mediante pielolitotomía abierta. Conclusión: El conocimiento de la clínica y de los hallazgos radiológicos de la extravasación urinaria espontánea por litiasis ureteral en las distintas pruebas de imágenes son cruciales para el manejo de los pacientes afectados por esta infrecuente complicación...

Spontaneous extravasation of urine, described by Albarran and published by Sole was considered a rare radiological finding in 198 and defined as the flow of urine out of the urinary tract in the absence of trauma, previous surgery or recent nor no history of urological instrumentation or excretory urography performed with external compression. We report a patient of 28 years, with no history of interest came with asthenia of 1 month’s duration, associated with pain in left lumbar fossa. That was studied by ultrasound and computed tomography (CT). The radiological identified multiple stones in proximal and distal left ureter. Collection bulky low density surrounding the left kidney limited by suggesting pararenal urinoma fascia, identifying continuity solution upper calyx, which communicates with the urinoma. The patient’s initial treatment was percutaneous nephrostomy placement of urgency for later ascension of the stones with ureteroscopy and removal of these by open pyelolithotomy. The knowledge of the clinical and radiological findings of spontaneous urinary extravasation with ureteral stones in various imaging tests are crucial for the management of patients affected by this rare complication...

Retroperitoneal laparoscopic pyelolithotomy in the treatment of intrarenal pelvic calculi / 中华泌尿外科杂志

Objective To evaluate the clinical efficacy and safety of retroperitoneal laparoscopic pyelolithotomy in the treatment of intrarenal pelvic staghorn calculus or multiple renal calculi. Methods Fifteen patients(9 males and 6 females)with average age of 40 years old were treated. The diameters of the calculi were from 1.5 cm to 3.7 cm. Three trocars were used in this procedure as rou-tine. The renal sinus was exposed by separating the pelvis from outside to inside until reaching the in-fundibulum of the renal calyx. Then the renal calyx was cut open and the calculus was taken out. Double J stent was placed in the ureter and the incision of pelvis was closed by 3-0 absorbable suture. The drainage tube was pulled out 3-4 d post-operatively according to the drainage quantity. Double J stent was then pulled out 2 weeks after surgery. Results All the 15 procedures were successfully completed. The average operation time was 170 min and the average post-operative hospital stay was 7 d. During the 3-15 months' follow-up, 2 patients had calculus remnants with the size of 0. 2-0.5cm in diameter. Conclusions Retroperitoneal laparoscopic pyelolithotomy provides a minimally inva-sive treatment option in patients with intrarenal pelvic staghorn calculus or multiple renal calculi. It has the advantages of good exposure, little bleeding, small incision and fast recovery.

Percutaneous nephrolithotomy vs open pyelolithotomy for renal pelvis calculi.

Objective: To compare the stone free rate and morbidity of percutaneous nephrolithotomy (PCNL) and open pyelolithotomy for a single renal pelvis stone. Patients and methods: A retrospective study was performed by reviewing case records of patients who underwent stone removal surgery between August 1994 and March 1999. The inclusion criteria was a single renal pelvis stone which was not smaller than 3 cm2 in surface area. Patients in the open pyelolithotomy group who had concurrent nephrotomies were excluded. There were a total of 46 patients of which 25 had undergone PCNL and 21 had undergone pyelolithotomy. Both groups were compared in terms of age, sex, stone surface area, haematocrit, blood urea nitrogen, serum creatinine, operative time, complications, stone free rate, adjunctive procedures, doses of postoperative analgesic injection, length of hospital stay, and time to return to normal work. Statistical analysis was performed by Chi-square test and t-test. Results: Preoperative status of the two groups were similar. The operative time was comparable between the two groups. The stone free rate of the PCNL group and the pyelolithotomy group were 92% and 95% respectively which was not statistically different. Five patients in the PCNL group needed ancillary procedures while only one patient in pyelolithotomy group did. Overall complications of the PCNL group and the pyelolithotomy group were 28.6% and 28% respectively which were comparable. Severe bleeding due to arterio-venous fistula occurred in 2 patients of the PCNL group. However, the complication could be managed successfully by selective embolisation. Disruption of uretero-pelvic junction occurred in one patient of the pyelolithotomy group and was repaired successfully. The number of doses of postoperative pethidine injection to lessen pain was lower in the PCNL group when compared with the pyelolithotomy group (mean 0.96 dose vs 1.95 doses, p<0.003). Length of hospital stay was comparable between the two groups. Time to return to normal work was shorter in the PCNL group when compared with the pyelolithotomy group (mean 13.7 days vs 36.3 days, p<0.001). Conclusions: PCNL is a safe and effective method to treat renal pelvis stones compared to open pyelolithotomy and offers less postoperative discomfort and shorter recovery period.

Experiences with a New Technique of Nephrolithotomy in Removing Renal Caliceal Calculi / 대한비뇨기과학회지

A new technique of nephrolithotomy was used to remove calyceal stone in seven cases. Key points of this technique are direct removal of stone through the calicopuncture by forceps without renal vascular clamping and Gelfoam Packing followed by compression with hands for control of bleeding. The results were s follow : 1. With the exception of a single small stone all the targeted calculi were removed (94% in completeness of stone removal). 2. This method did not have any significant renal parenchymal damage and there was no episode of postoperative urine leakage of delayed bleeding. 3. Postoperative complications were a case of urinary obstruction caused by slipped Gelfoam into calyx accidently, which was delivered spontaneously during the voiding on 2nd postoperative day and a case of wound infection. This new technique nephrolithotomy was seemed to be an useful and rapid surgical method of calyceal stone surgery in some situations such as in case of marked adhesion present around the pelvis, narrow infundibulum and failed stone removal during the performing pyelolithotomy.

Surgical Management of Renal Calculi / 대한비뇨기과학회지

A clinical evaluation was made with particular attention to surgical management on 156 patients with renal calculi who had been admitted to the Department of Urology, Kyungpook National University Hospital during 1O years periods from January, 1976 to December, l985. The results were as follows: 1. The calculus was unilateral in 144 patients (right in 73 and left in 71) and bilateral in l2.57 patients had staghorn calculi, 62 either single or multiple pelvic calculi, 20 either single or multiple calyceal calculi, and 17 multiple pelvic and calyceal calculi. 2. The treatment modality was surgical intervention in l39 patients(143 operations) and conservative management in 17.143 surgical interventions were nephrectomy in 17 and conservative surgery in 126. Conservative surgery was simple pyelolithotomy in 14, extended pyelolithotomy in 59, extended pyelolithotomy with parenchymal extension in 21, radial nephrolithotomy in 4, anatrophic nephrolithotomy in l4, partial nephrectomy in l3, and extended pyelolithotomy with ureterocalycostomy in 1. 41 operations with nephrotomy were done using in situ hypothermia. 3. 60 surgical interventions for pelvic calculi were simple pyelolithotomy in 14, extended pyelolithotomy in 40, extended pyelolithotomy with parenchymal extension in 2, and nephrectomy in 4.l9 surgical interventions for calyceal calculi were extended pyelolithotomy in 4, extended pyelolithotomy with parenchymal extension in 4, radial nephrolithotomy in 3, partial nephrectomy in 6, and nephrectomy in 2. 14 surgical interventions for pelvic and calyceal calculi were extended pyelolithotomy in 1, extended pyelolithotomy with parenchymal extension in 3, radial nephrolithotomy in l, anatrophic nephrolithotomy in 2, and partial nephrectomy in 5. 50 surgical interventions for stag horn calculi were extended pyelolithotomy in 14, extended pyelolithotomy with parenchymal extension in 2, anatrophic nephrolithotomy in 14, partial nephrectomy in 5, and nephrectomy in 6. 4. Except for 15 cases with remnant calculi and 1 with nephrectomy, no mortality nor significant morbidity was found 126 cases with renal calculi treated by conservative surgery. Cases found to have remnant calculi after surgical procedures were 1 out of 14 pyelolithotomies, 6 out of 59 extended pyelolithotomies, 4 out of 21 extended pyelolithotomy with parenchymal 2 extension, out of 14 anatrophic nephrolithotomies, and 1 out of 4 radial nephrolithotomies.

Coagulum Pyelolithotomy and Nephrolithotomy / 대한비뇨기과학회지

Successful removal of staghorn and multiple renal calculi has been one of the mist difficult tasks that confront the urologists. The operative method for removal of the renal calculi was selected according to the size, number, location and anatomic features of the renal collecting system. We utilized the coagulum to improve the success of the stone removal for last five months. The coagulum material were mixed in a ratio of 5ml cryoprecipitate or 4% fibrinogen: 1ml 20 unit /ml human thrombin:0.2ml 10% calcium chloride. The results were as follows. 1. The patients were provided by 3 coagulum pyelolithotomy and 6 coagulum nephrolithotomy, of which utilized cryoprecipitate in 7 cases and 4% fibrinogen in 2 for the fibrinogen source. 2. The seven of nine cases(78.2%) were successfully removed without residual stone, but incompletely in two cases(22.2%). 3. Nondemonstrable stone of the preliminary film were removed additionally in one cases(11.1%). 4. As to the complication, meaningless wound infection and dehiscence was observed in only one case. On basis of our experiences, present here a histologic perspectives, methods, cases and its results, in dication and contraindication for coagulum pyelolithotomy and nephrolithotomy.

Clinical Experience Using the Trumpet-Shaped 8F Nelaton Catheter as Ureteral Stent in Extended Pyelolithotomy / 대한비뇨기과학회지

Because there is difficulty in the suture of renal pelvis, extended pyelolithotomy for the renal or pelvic calculi gives often complication such as urine leakage or infection, which result in the fibrosis and stricture of the region. Seven cases of renal stones are treated with new method using 8F Trumpet-shaped Nelaton Catheter. The proximal portion of the Nelaton Catheter inserted into the renal pelvis through the incised opening is made to arrive the lumen of the urinary bladder and the Trumpet-shaped distal portion is made to fix with the suture of the renal pelvis and capsules. After five to seven days, the catheter is removed by cystoscopic manipulation. It seems that the method is easy and feasible to decrease the complication of the extended pyelolithotomy for renal calculi.

Surgical Management of Renal Calculi with Extended Pyelolithotomy / 대한비뇨기과학회지

An ideal operation for removal of renal calculi should allow minimal destruction of renal parenchyma, complete removal of calculus, provision of a normal drainage urinary system and establishment of an infection-free urinary system. In 1965, Gil Vernet revived the extended pyelolithotomy in surgical approach for renal calculi. This technique provides accessibility to infundibular and calyceal calculi, intrarenal pelvic calculi and staghorn calculi and can be used effectively in combination with nephrotomy for large staghorn calculi. The authors applied this procedure to 46 patients with renal calculi in this department during 3 years and 8 months periods from January, 1980 to August, 1983. Seven patients had a staghorn calculus, 12 either single or multiple calyceal calculi, 8 multiple pelvic and calyceal calculi and 19 single or multiple pelvic calculi (16 intrarenal and 3 extrarenal). There were no mortality and significant morbidity related to this technique except two cases with remnant calculi.

Surgical Management of Renal Calculi with Extended Pyelolithotomy / 대한비뇨기과학회지

An ideal operation for removal of renal calculi should allow minimal destruction of renal parenchyma, complete removal of calculus, provision of a normal drainage urinary system and establishment of an infection-free urinary system. In 1965, Gil Vernet revived the extended pyelolithotomy in surgical approach for renal calculi. This technique provides accessibility to infundibular and calyceal calculi, intrarenal pelvic calculi and staghorn calculi and can be used effectively in combination with nephrotomy for large staghorn calculi. The authors applied this procedure to 46 patients with renal calculi in this department during 3 years and 8 months periods from January, 1980 to August, 1983. Seven patients had a staghorn calculus, 12 either single or multiple calyceal calculi, 8 multiple pelvic and calyceal calculi and 19 single or multiple pelvic calculi (16 intrarenal and 3 extrarenal). There were no mortality and significant morbidity related to this technique except two cases with remnant calculi.

Extended Pyelolithotomy in Staghorn Calculi / 대한비뇨기과학회지

A retrospective study was conducted on 10 patients who had undergone extended pyelolithotomy for staghorn calculi. There were some complications which were such as retained stones in 3 cases, urine leak 1 case, pneumothorax 1 case, but this surgical technique was relatively simple and easy for patients with staghorn calculi disease.

A Clinical Study on Surgery of Renal Stones / 대한비뇨기과학회지

The surgical removal of dendritic calculi, isolated symptomatic calyceal calculi and large calculi from within the intrarenal pelvis has been always a difficult problem and can be destructive to renal parenchyma. following results are obtained through comparative investigation among extended pyelolithotomy, nephropyelolithotomy, anatrophic nephrolithotomy with hypothermia in situ and nephrectomy for surgery of renal stones. Among these methods, anatrophic nephrolithotomy with hypothermia in situ is performed in 12 cases who have renal stones which are considered to be difficult to remove by ordinary pyelolithotomy. This operative technique is relatively simple, easy and uneventful recovery followed in all cases. 1. Incidence of renal stones is 48 cases out of 618 total in-patients. 2. The sex distribution: 26 patients are male and 22 patients are female. 3. the age distribution ranged from 7 years old to 72 years old with the most common age group in the 31-50 years old. 4. Methods of operative management included: extended pyelolithotomy in 22 cases, anatrophic nephrolithotomy with hypothermia in situ in 12 cases, nephropyelolithotomy in 2 cases and nephrectomy in 12 cases. 5. Blood loss during operation by anatrophic nephrolithotomy with hypothermia in situ, as compared with nephropyelolithotomy is reduced to a quarter. 6. Operating time by anatrophic nephrolithotomy with hypothermia in situ required 95 minutes with mean operating time, extended pyelolithotomy-85 minutes with mean operating time, nephro-pyelolithotomy-120 minutes with mean operating time. 7. Postoperative hospitalizations are 9 days in anatrophic nephrolithotomy with hypothermia in situ, 8 days in extended pyelolithotomy, 15 days in nephropyelolithotomy and 8 days in nephrectomy.

A Clinical Study on Surgery of Renal Stones / 대한비뇨기과학회지

The surgical removal of dendritic calculi, isolated symptomatic calyceal calculi and large calculi from within the intrarenal pelvis has been always a difficult problem and can be destructive to renal parenchyma. following results are obtained through comparative investigation among extended pyelolithotomy, nephropyelolithotomy, anatrophic nephrolithotomy with hypothermia in situ and nephrectomy for surgery of renal stones. Among these methods, anatrophic nephrolithotomy with hypothermia in situ is performed in 12 cases who have renal stones which are considered to be difficult to remove by ordinary pyelolithotomy. This operative technique is relatively simple, easy and uneventful recovery followed in all cases. 1. Incidence of renal stones is 48 cases out of 618 total in-patients. 2. The sex distribution: 26 patients are male and 22 patients are female. 3. the age distribution ranged from 7 years old to 72 years old with the most common age group in the 31-50 years old. 4. Methods of operative management included: extended pyelolithotomy in 22 cases, anatrophic nephrolithotomy with hypothermia in situ in 12 cases, nephropyelolithotomy in 2 cases and nephrectomy in 12 cases. 5. Blood loss during operation by anatrophic nephrolithotomy with hypothermia in situ, as compared with nephropyelolithotomy is reduced to a quarter. 6. Operating time by anatrophic nephrolithotomy with hypothermia in situ required 95 minutes with mean operating time, extended pyelolithotomy-85 minutes with mean operating time, nephro-pyelolithotomy-120 minutes with mean operating time. 7. Postoperative hospitalizations are 9 days in anatrophic nephrolithotomy with hypothermia in situ, 8 days in extended pyelolithotomy, 15 days in nephropyelolithotomy and 8 days in nephrectomy.