ギロチン法による腎部分別除術の研究

Abstract

The purpose of this report is to introduce Guillotine t echnique for partial nephrectomy. This method is designed to secure hemostasis in solely prospective resection area. In contrast to the usual clamping on the vascular pedicle, it is found that b lood circulation is well maintained and anoxia is avoided in the rest of kidney by this techniq ue. A. Clinical Study. 1. The autho r devised a clamp for this technique. 2. The clinical result of partial nephrect o my at our Department has remarkably improved after adoption of Guillotine technique and improvement of suturing. 3. Compared with the previous methods, postoperative clearance r ecovered rapidly and duration of postoperative hematuria markedly shortened in the cases operated with Guillotine technique. B . Experimental Study. 1. To study this t e c hnique in the animal, a clamp was devised. 2. By the renal artery angiography in the dog, it is c onfirmed that this technique secures hemostasis in the resection area and preserves blood circulation in th e rest of the kidney. 3 . Examination of the tissues removed from the site of resection, a remote area on the operated side and unaffected kidney of the dog, which had been undertaken parti al nephrectomy with Guillotine technique, revealed milder influence by surgery. 4. Spread of thrombin powder over the resected surface is fou n d to be effective by histological examination. C. Conc l u sion. As m e ntioned above, Guillotine technique using a clamp devised by the author is definitely advantageous than the previous methods for partial nephrectomy.