‘pyelolithotomy’

Kidney Transplant Surgery

Saturday, July 24th, 2010

Transplant To speak of renal transplantation in scientific terms must go back to the early twentieth century when Ullmann in 1902 announced the first kidney transplant in a dog, but it’s the middle of this century when this surgery becomes a real treatment option, especially from 1954 when Murray performed the first successful transplant between twin brothers.

The technique of transplantation has changed little over the decades, confined, in most cases, heterotopic in its location at the level of the iliac fossa with anastomosis of renal artery and vein to the external iliac vein and artery and ureter to the bladder as different techniques uréterocisto-neostomía.

There has been much evolution of surgical techniques but the emergence of new and improved immunosuppressive the cause of the excellent results obtained in the graft survival rate, reaching 90% in the first year in the most experienced centers, Although we must not forget that the best knowledge and management of the arteries and veins and the use of vascular patches have allowed a group of transplanted kidneys that were discarded years ago. (more…)

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Surgery on Kidney Infection

Wednesday, July 21st, 2010

kidney infectionIf we review the classic texts of the century the management of perinephric and renal abscesses pyonephrosis was surgical, and in many cases involved the complete removal of the kidney, today the situation is quite different and distinct depending on the type of infection.

In cortical or corticomedullary abscesses would be exceptional to indicate an aggressive therapeutic because, in most cases, will respond to parenteral antibiotic therapy, provided they are broad spectrum and stay at least 12-14 days.

As regards perinephric abscess treatment is based on the complete draining of the collection, along with proper antibiotic coverage. With this management are cured between 60-90% of these abscesses, only in the event that, by the complexity of multiple abscess cavities or the density of debris do not allow proper drainage, surgical debridement is indicated conventional sometimes associated with nephrectomy for renal cancellation irreversible. (more…)

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Surgery of Renal Stones

Saturday, July 17th, 2010

Kidney StonesThe role of surgery before the kidney stone disease has undergone in the last twenty years a significant involution, passing on most services accounted for some 30% of the surgery that it is almost testimonial.

Have virtually disappeared or been reduced to a minimum classical techniques as were the pyelolithotomy, the radial nephrotomy the nephrotomy anatrófica.

Yet given the use of more modern, less invasive, such as percutaneous renal lithotripsy and extracorporeal shock wave lithotripsy, you should not forget basic concepts in the management of the stone and are targets to be achieved to indicate different therapeutic from They would emphasize:

- Elimination of stones and fragments as complete as possible.

- Normalize the urinary drainage

- Preserve the maximum renal function.

- To eradicate the infection.

- Prevent recurrence.

(more…)

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