‘renal supracostal’

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…)

Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , ,
Posted in renal surgery | No Comments »

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…)

Tags: , , , , , , , , , , , , , , , , , , ,
Posted in renal surgery | No Comments »

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…)

Tags: , , , , , , , , , , , , , , , ,
Posted in renal surgery | No Comments »

Surgery in Renal Cancer

Wednesday, July 14th, 2010

Renal CancerAny surgery has to be planned taking into consideration both the pathology to be treated as patient characteristics.

Until the decade of the 90 conventional surgery in renal adenocarcinoma was radical nephrectomy, which involves the removal of Gerota’s fascia and its contents the kidney, perirenal fat and adrenal tumors whether it was upper pole.

Still in dispute has been whether or not to perform regional lymphadenectomy latero-caval chains in the right side and latero-aortic left, due in part to poor prognosis when lymph node and also clear the lymphatic drainage of renal tumors is variable and may reach different areas of the retroperitoneum and even the mediastinum.

The surgical approach depends more on personal preference than simply surgical or oncology criteria. There was a time where I was almost banned the retroperitoneal and transabdominal is advocated as the approach that met the most rigorous oncological premises, avoiding the manipulation before clamping the renal pedicle.

(more…)

Tags: , , , , , , , , , , , , ,
Posted in renal surgery | No Comments »

Percutaneous Renal Surgery

Saturday, July 10th, 2010

Renal Surgery Percutaneous renal surgery is a very important role in the management of different pathologies such as urinary stones, strictures of the union U / P and ureteral tumors of the upper tract collecting system, diagnostic and derivative nephrostomy. Percutaneous renal surgery is an important part of the surgical techniques that dominate the modern urologist. The percutaneous supracostal to access the upper calyx allows adequate vision of the chalices and most of the ureteropelvic junction (U / P), but the drawback is the possible damage to the pleura, which is why we review our experience. It is a retrospective study analyzing the morbidity associated with renal supracostal and subcostal puncture.

(more…)

Tags: , , , , , , , , ,
Posted in renal surgery | No Comments »