Urolithiasis pp 133-140 | Cite as

Ischemia and Regional Hypothermia in Renal Stone Surgery

  • H.-J. Schneider
Part of the Handbook of Urology book series (HDB.UROLOGY, volume 17/2)

Abstract

The aim of renal stone surgery must be the complete clerance of all calculous material. Residual stones grow, provoke the formation of new calculi and hinder the resolution of Pyelonephritis. An attempt should always first be made to extract the stones through a pyelotomy or an extended intrasinusal pyelocalycotomy. Nevertheless, it is often impossible to avoid extensive or multiple incision of the parenchyma and this inevitably entails ischemia: a bloodless surgical field is the sine qua non for the complete retrieval and extraction of calculi. However, if ischemia is extended beyond 20 or maximally 30 minutes, there will be loss of renal function of varying severity postoperatively, occasionally even renal atrophy. Retarding renal metabolism, either by pharmacologically active substances or by hypothermia, is a safe way to prolong renal ischemia time.

Keywords

Catheter Glycerine Hydration Ischemia Lactate 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1986

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  • H.-J. Schneider

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