An experimental study measuring arterial injury in vitro porcine kidney in different sizes of nephrostomy tracts / 中华泌尿外科杂志

Objective To investigate the arterial injury in vitro porcine kidney to different size of nephrostomy tracts. Methods The technique of percutaneous nephrostomy was applied to establish 11 groups of different size of nephrostomy tracts from 12 F to 32 F,with 40 tracts in every group.The technique of digital subtraction angiography (DSA) was used to inspect and analyze arterial injury. Results In the range from 12 F to 32 F,the damage of arterial injury increased with the size of the tract diameter.In groups of 20 F and 32 F,the number of nephrostomy tracts with serious arterial injury was 18 (18/40) and 30 (30/40) respectively,and the difference was statistically significant (P＜0.05).There was no statistical difference between groups 18 F、20 F、and 22 F. Conclusions The damage of renal arterial injury increased with the size of the nephrostomy tract.Atract of 20 F reduees arterial injury compared with a tract of 32 F.

Endoscopic treatment of benign ureterointestinal anastomotic strictures in patients with urinary diversion / 中华泌尿外科杂志

Objective To evaluate the clinical efficacy of endourologic treatment of benign uret-erointestinal anastomotic strictures in patients with urinary diversion. Methods Nine cases of benign ureterointestinal anastomotic strictures with a length of 1-3 cm following radical cystectomy and uri-nary diversion accepted endourologic treatment. 8 cases were treated by antegrade percutaneous ap-proach, 1 case by retrograde ureteroscopic approach. The strictures received balloon dilation, and ure-teral stents indewelled. Results In a follow up of 0.5-5.0 years, 1 case received percutaneous ne-phrostomy for complete ureterointestinal anastomotic atresia and refused to open operation reconstruc-tion. 5 cases had no recurrence after 2-3 endoscopic sessions. 3 cases needed long time ureteral stents indwelled. Conclusion Endourological technique for ureterointestinal strictures following urinary di-version avoided the disadvantages of open operation.

Character and significance of renal pelvic pressure in minimally invasive percutaneous nephrolithotomy / 中华泌尿外科杂志

Objective To investigate the renal pelvic pressure(RPP) during minimally invasivepereutaneous nephrolithotomy(MPCNL),and inspect its influence to postoperative fever. MethodsThe RPP was measured by baroeeptor,and these data about pressure and postoperative fever wereevaluated statistically. Results The mean RPP was 14.72 mm Hg,the mean accumulative time of RPP≥30 mm Hg was 116.06 s. Fifteen cases(18. 75%)had a postoperative fever. Logistical analysissuggested that postoperative fever did not correlate to sex(P=0.195),age(P=0.641),urinary tractinfection (P=0.663),white blood cell≥10 × 109/L in blood routine examination postoperatively (P=0.751),once an occurrence of RPP≥40 mm Hg(P=0.662),while infection calculi (P=0.000),percutaneous tract size(P=0.029),mean RPP(P=0.036) ,mean RPP≥20 mm Hg(P=0.013),accumulative time of RPP≥30 mm Hg(P=0.010) and RPP≥30 mm Hg longer than 50 s(P=0.024)contributed to postoperative fever. Conclusions Renal pelvic pressure generally remains lower than alevel to back flow (30 mm Hg) during MPCNL. A transient renal pelvic pressure≥30 mm Hg don'tcountribute to postoperative fever,while a temporary high pressure status(50 s)would had an accumulated effect which means an enough back flow to bring a fever.