Advertisement

250 Cases of Complicated Nephrolithotomy under Regional Hypothermia

  • J. E. A. Wickham
Conference paper
Part of the Fortschritte der Urologie und Nephrologie book series (2824, volume 17)

Abstract

Approximately one third of all patients referred for nephrolithotomy require an incision of some sort to be made in the renal parenchyma for adequate stone removal. For accurate surgery to be performed and to avoid unnecessary exanguination it is now well recognised that temporary vascular arrest should be produced by occlusion of the renal artery or whole pedicle. Renal ischaemia at 37°C can be permitted for 10–15 minutes but after this time renal function deteriorates rapidly. Functional preservation can be achieved by local renal cooling to 15°–20°C and operating periods of up to 3 hours are well tolerated (Wickham 1967; Ward 1975).

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Ward, J. P.: Determination of the optimum temperature for regional renal hypothermia during temporary renal ischaemia. British Journal of Urology, 47: 17–24 (1975).PubMedCrossRefGoogle Scholar
  2. Wickham, J. E. A., Hanley, H. G. and Joekes, A. M.: Regional renal hypothermia. British Journal of Urology, 39: 727–743 (1967).PubMedCrossRefGoogle Scholar
  3. Gardiner, R. A. and Wickham, J. E. A.: The modified lumbotomy incision. British Journal of Urology, 00: 000 (1979).Google Scholar
  4. Wickham, J. E. A., Coe, N. and Ward, J. P.: One hundred cases of nephrolithotomy under hypothermia. Journal of Urology, 112: 702–705 (1974).PubMedGoogle Scholar
  5. Witherow, R. O. N. and Wickham, J. E. A.: Nephrolithotomy in chronic renal failure: saved from dialysis. British Journal of Urology, 52: 419–421 (1980).PubMedCrossRefGoogle Scholar
  6. Gil-Vernet, J.: New surgical concepts in removing renal calculi. Urologica Internationalis 20: 255–288 (1965).CrossRefGoogle Scholar
  7. Fitzpatrick, J. M., Sleight, M. W., Braack, A., Marberger, M. and Wickham, J. E. A.: Intrarenal access: effects on renal function and morphology. British Journal of Urology 52: 409–414 (1980).PubMedCrossRefGoogle Scholar
  8. Boyce, W. H.: In: Renal Calculi in Urologic Surgery, 2nd Edition. James Glenn (ed), pp. 169–189. Hagerstown: Harper and Row (1975).Google Scholar
  9. Graves, F. T.: Renal hypothermia: an aid to partial nephrectomy. British Journal Surgery, 50: 362–367 (1963).CrossRefGoogle Scholar
  10. Williams, R. E.: Long term study of 538 patients with upper urinary tract stone. British Journal of Urology, 35: 416 (1963).PubMedCrossRefGoogle Scholar
  11. Singh, M., Tresidder, G. C. and Blandy, J.: The long term results of removal of staghorn calculi by extended pyelolithotomy without cooling or renal artery occlusion. British Journal of Urology, 43: 658–664 (1971).PubMedCrossRefGoogle Scholar

Copyright information

© Dr. Dietrich Steinkopff-Verlag, GmbH & Co. KG, Darmstadt 1982

Authors and Affiliations

  • J. E. A. Wickham
    • 1
    • 2
    • 3
  1. 1.Department of UrologySt. Bartholomew’s HospitalLondonUK
  2. 2.St. Paul’s HospitalInstitute of Urology, University of LondonUK
  3. 3.LondonEngland

Personalised recommendations