Coagulum Pyelolithotomy51症例の経験

Abstract

Previously, I reported the successful results of coagulum pyelolithotomy with autogenous plasma and bovine thrombin. Herein, 51 cases of coagulum pyelolithotomy using commercial human fibrinogen which is more simple and easy to use are described. In an experimental study, human fibrinogen and bovine thrombin were confirmed as the most suitable materials for this procedure and fibrin clots of the available tensile strength were obtained by the 5: 1 mixture of 4% fibrinogen and 30 Units/ml thrombin. The patients provided by coagulum pyelolithotomy included 10 with multiple renal stones, 30 with ureteral stone as well as renal stones and 11 cases with only upper ureteral stone in addition. The results were as follows: All demonstrable stones were removed in 30 cases, all demonstrable stones as well as non-demonstrable stones were removed in 5 cases, stones were removed, but incompletely in 6 cases, and no stone was in the renal pelvis in 10 cases. Coagulum pyelolithotomy is an effective way of safely removing multiple small calculi in the renal pelvis and also to reduce the incidence of stone recurrence including so called false recurrence. I recommend the more widespread use of this procedure in properly indicated cases.