ANATROPHIC NEPHROLITHOTOMY PDF
Introduction. Anatrophic nephrolithotomy is a procedure in which a parenchymal incision is made in an intersegmental plane, allowing removal of large renal. We offered the patient staged open anatrophic nephrolithotomy. Results. Operative time was minutes. Blood loss was cc. requiring one. The anatrophic nephrolithotomy described by Smith and Boyce is an excellent method of preserving a maximum number of functioning nephrons by minimizing .
|Published (Last):||7 December 2017|
|PDF File Size:||13.47 Mb|
|ePub File Size:||7.56 Mb|
|Price:||Free* [*Free Regsitration Required]|
Case Reports in Urology
Article-Type of This Article. Surgical site infection was seen in two patients — Escherichia coli sensitive to piperacillin-tazobactam and cefoperazone-sulbactam preoperative urine culture sterile and urosepsis in two patients, urinary tract infection in E.
We present our experience of AN in our centre wherein we have performed more than procedures for renal calculi. The collecting system is reconstructed with absorbable suture, and special techniques are used to correct the infundibular stenosis.
However when cellular damage and morphological assessment are considered, renal damage becomes more evident. As in Al-Kohlany et al[ 46 ] study, results were not segregated by technique. Guidelines from American Urological Association and European Urology Association state that conventional excision of staghorn stones must be considered only in exceptional cases and that percutaneous nephrolithtomy PNL should be the preferred choice[ 12 ].
Surgical site infection was seen in 2 patients and urosepsis in 2 patients. El-Nahas et al [ 29 ]. Between April and JulyAN was done in 14 renal units in 13 patients.
A year-old female patient with a BMI of 36,2 was referred from General Medicine Department with a diagnosis of bilateral staghorn kidney stone, documented by an abdominal X-ray Anatrophci 1. InKaouk et al[ 20 ] studied laparoscopic ANL for the management of staghorn renal stone in pigs[ 20 ]. Morey AF et al. Current surgical approaches to nephrolithiasis. Pneumatic lithotripsy nepgrolithotomy pyelotomy incision during open surgery for staghorn calculi: Guidelines on Urolithiasis Case details of patients undergoing AN were retrieved from our institutional patient database.
Write to the Help Desk. Renal function was assessed with 99mTc-mercaptoacetyltriglycine MAG3 scans and no significant decline in the operated renal unit was observed, although, results were not segregated nepjrolithotomy technique. PNL was performed in 1, Nevertheless, the potential deleterious effect of ESWL on kidney structures is well established[ 4445 ] and the combination of PNL may have a greater impact on renal function.
November 17, Article in press: Even if anatrophic nephrolithotomy is currently performed laparoscopically, in patients affected by severe cardiac or pulmonary diseases or with a previous laparotomy, laparoscopic approach may not be indicated.
This paper presents one of such patients as well as a discussion of the modern indications for this technique. A percutaneous treatment was impractical due to stones volume and complexity, obesity, and low compliance of patient for possible need of repeat treatments. These records were assessed and analysed for this retrospective study.
After 3 months, a renal ultrasound showed no hydronephrosis, no left kidney calculi, and the persistence of right kidney staghorn calculi with a sufficiently represented parenchyma. The kidney was exposed through a flank incision on the 11th intercostal space. Serum urea nitrogen obtained to assess renal function and serum creatinine has improved or remained stable in all but 2 patients. This may be related to nephron injury during nephrotomy and parenchymal closure or to ischemic injury.
King et al[ 24 ] evaluated seven consecutive patients submitted to RANL.
Anatrophic Nephrolithotomy in the Management of Large Staghorn Calculi – A Single Centre Experience
Arterial clamp was released nephrolithootmy reapplied to allow suture of bleeding vessels with figure-of-8 sutures with vicryl. Comorbidities were obesity BMI Number of Hits and Downloads for This Article.
Right ratio was 9: Laparoscopic anatrophic nephrolithotomy for management of staghorn renal calculi. The effects of percutaneous nephrolithotomy on renal function in geriatric patients in the early postoperative period. A retroperitoneal drain was placed.
Journal Information of This Article. While previously, the majority of patients required an open surgical approach, today less invasive procedures, such as extracorporeal shock waves lithotripsy ESWLureterorenoscopy URSand percutaneous nephrolithotripsy PNLhave promoted a rapid decrease of the use of open surgery for both ureteral and renal stones [ 12 ]. Thomas et al[ 12 ] used I hippuran scanning to assess renal function of thirteen patients operated on with classic ANL with a mean follow up of A nephrotomy was made along the previously defined anatrophic plane.