250 Cases of Complicated Nephrolithotomy under Regional Hypothermia

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).