腎結石に対する腎体外手術について

Abstract

We report 2 cases in which extracorporeal renal surgery was successful for complicated staghorn calculi, and demonstrate its usefulness from biochemical and histological studies on hypothermia in the ischemic kidney of rats. The technique and indications for extracorporeal renal surgery for renal stone disease are also discussed. Though the surgical technique is almost established, there is much debate about the indications for extracorporeal surgery in the management of renal stone disease. Extracorporeal surgery might be indicated for extensive renal stones where numerous stone fragments adhere to pyelocalyceal mucosa, for a staghorn calculus contained in a solitary kidney, particularly when a previous surgery had been performed for stone disease in the same kidney, and for complicated renal stones in a kidney with pyelocalyceal, renovascular or ureteral lesions needing surgical repair. In selected cases, extracorporeal surgery will provide a better result that the in situ procedures, However, long-term results with extracorporeal surgery should be compared to those obtained by conventional methods.