A Clinical Study on Surgery of Renal Stones

Kim, Bong Guk; Park, Young Kyung

Abstract

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.