scholarly journals The results of open surgical treatment of bilateral staghorn and multiple nephrolithiasis

2018 ◽  
Vol 99 (4) ◽  
pp. 722-729
Author(s):  
S B Imamverdiev ◽  
T A Talibov ◽  
I F Makhmudov
Keyword(s):  
Surgical Treatment ◽  
Renal Artery ◽  
Open Surgery ◽  
Left Kidney ◽  
The Other ◽  
Before And After ◽  
The Status ◽  
Group 2 ◽  
Open Surgical Treatment ◽  
The Right

Aim. To determine the status and to increase the effectiveness of open surgical treatment of bilateral staghorn nephrolithiasis. Methods. We studied the results of surgical treatment of 250 patients who underwent open surgery for severe forms of bilateral staghorn nephrolithiasis. The patients were divided into four groups according to the features of changes in both kidneys and ureters - group 1 included 125 (50.0%) patients with bilateral staghorn nephrolithiasis, group 2 - 35 (14.0%) patients with staghorn nephrolithiasis of solitary or the only functioning kidney, 70 (28.0%) patients with unilateral staghorn nephrolithiasis and solitary or multiple kidney or ureter stones on the other side were included into group 3, and group 4 inlcuded 20 (8.0%) patients with unilateral staghorn nephrolithiasis and nonobstructive hydronephrosis and other diseases on the other side. The age of patients ranged from 7 to 76 years old, ranging among children from 7 to 18 years (average age 12.1±0.4 years) and among adults from 19 to 76 years (average age 46.4±0.6 years). Among patients, 121 (48.4%) were males and 129 (51.6%) were females. Results. Surgical tactics and the results of performed surgeries in certain groups were studied. Overall, 127 (50.8±3.8%) of 250 patients underwent surgery on the right kidney, and 123 (49.2±3.2%) - on the left kidney. To achieve minimal blood loss during the surgery, in 20% of cases renal artery was clamped. To protect kidneys from ischemia, 3 mg/kg of furosemide, 0.2 mg/kg of verapamil and 1 mg/kg of methylethylpiridinol were used before and after clamping of the renal artery. Open surgical treatment of 250 patients with bilateral staghorn nephrolithiasis was successful in 246 (98.4±0.8%) patients. In case of residual stones, extracorporeal or ureterorenoscopic shock wave lithotripsy was performed. Conclusion. Despite the wide application of modern endoscopic methods of therapy in the treatment of this group of patients, in complex forms of staghorn nephrolithiasis open surgery is more effective.

scholarly journals Renal artery stenosis of atherosclerotic etiology – the single kidney surgical recurrence 12 years after nephrectomy

2016 ◽  
Vol 63 (3) ◽  
pp. 251-254
Author(s):  
Maria Daniela Tănăsescu ◽  
◽  
Marcel Pălămar ◽  
Mihai Ovidiu Comşa ◽  
Alexandru Mincă ◽  
...  
Keyword(s):  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Left Kidney ◽  
Secondary Hypertension ◽  
Artery Stenosis ◽  
The Other ◽  
Left Renal Artery ◽  
Arterial Blood ◽  
The Moment ◽  
The Right

Objectives. Renal artery stenosis, as main cause of renovascular secondary hypertension, is mainly caused by atherosclerosis of large vessels and is clinically characterized by resistant or malignant hypertension, impacting the kidney function to various degrees. The present article brings into attention the case of a patient which developed renal artery stenosis on the left kidney, the same condition occurring 12 years later on the right kidney. Material and method. Our patient was initially diagnosed at the age of 48 with complete occlusion of the left renal artery, for which left nephrectomy was performed, while the right artery was normal. Twelve years later she presents with renal artery stenosis on the right kidney, which is treat by stent-angioplasty. Results. After surgery, the patient’s evolution was positive, with amelioration of the laboratory values, in parallel to the arterial blood pressure. Discussions. The probability that, in the moment of diagnosis of renal artery stenosis with progressive evolution to occlusion caused by atherosclerosis, the other artery would be normal, both seen by ultrasonography and angiography, while years later to develop stenosis, is minimal. Up to present, the literature holds little evidence of such similar cases. Conclusions. In the particular case of patients that were diagnosed with severe renal artery stenosis of atherosclerotic origin and had only one of the arteries affected, it is necessary to keep a permanent monitoring, justified by the risk of development of the same pathology to the other artery

Ex Vivo Repair of a Renal Artery Saccular Aneurysm in a Living-Nonrelated Donor and Subsequent Successful Kidney Transplantation

2018 ◽  
Vol 52 (6) ◽  
pp. 455-458
Author(s):  
Rogerio A. Muñoz-Vigna ◽  
Javier E. Anaya-Ayala ◽  
Juan N. Ramirez-Robles ◽  
Daniel Nuño-Diaz ◽  
Sandra Olivares-Cruz
Keyword(s):  
Kidney Transplantation ◽  
Renal Artery ◽  
Ex Vivo ◽  
Incidental Finding ◽  
Left Kidney ◽  
Renal Arteries ◽  
Saccular Aneurysm ◽  
Preoperative Imaging ◽  
The Right ◽  
Stage Renal Disease

The use of kidney grafts with aneurysmal disease involving the renal arteries for transplantation is very uncommon and relatively controversial. We herein present the case of a 52-year-old woman who volunteered to become a living-nonrelated donor; during the preoperative imaging workup, a computed tomography angiography revealed a 1.5-cm saccular aneurysm in the left kidney, while the contralateral renal artery was normal. We decided to utilize the left kidney for a 25-year-old male patient with end-stage renal disease, and following the ex vivo repair using the recipient epigastric vessels and saphenous veins, we completed the transplantation in the right pelvic fossa. The postoperative period was uneventful, and at 8 months from the surgery, the graft remains functional. The surgical repair of renal artery aneurysms followed by immediate kidney transplantation is a safe technique and an effective replacement therapy for recipients. The incidental finding of isolated aneurysmal disease in renal arteries should not exclude graft potential availability for transplantation following repair.

scholarly journals Surgical treatment for common hepatic aneurysm. Original one-step technique

Open Medicine ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. 898-904
Author(s):  
Bruno Amato ◽  
Renato Patrone ◽  
Gennaro Quarto ◽  
Rita Compagna ◽  
Roberto Cirocchi ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hepatic Artery ◽  
Distal Part ◽  
Intraoperative Ultrasound ◽  
Section Area ◽  
One Step ◽  
A New Technique ◽  
Open Surgical Treatment ◽  
The Right ◽  
Vascular Stapler

AbstractIntroductionHepatic artery aneurysms are rare, and their treatment represents a challenge for the surgeons.Materials and methodsA new technique is presented for common hepatic artery (CHA) aneurysm: it requires minimal vascular surgical dissection and only one linear vascular stapler is applied at the bottom of aneurysm. Aneurysm exclusion is easily obtained, which allowed retrograde thrombosis. Liver blood supply is ensured to the right and left hepatic artery, through the gastroduodenal artery, and can be previously monitored, with temporary clamping of the section area, by visual control, enzyme evaluation and intraoperative ultrasound examination. We reported an open surgical treatment, with simultaneous removal of hepatic and adrenal metastases, secondary to colon cancer.ResultsThe duration of vascular surgery was 30 min and did not involve complications. Postoperative controls confirmed the efficacy of the procedure.DiscussionThis original technique can be added to the various open and endovascular techniques so far described for the treatment of a CHA aneurysm. It is advisable as open surgery, mostly in case of associated pathologies.ConclusionsThe authors believe that this “one shot” technique by vascular staple of the distal part of CHA is minimally invasive and effective to obtain the exclusion of the aneurysm.

scholarly journals Autotransplantacija slezine

2002 ◽  
Vol 49 (3) ◽  
pp. 101-106 ◽  
Author(s):  
S. Knezevic ◽  
D. Stefanovic ◽  
M. Petrovic ◽  
Z. Djordjevic ◽  
Slavko Matic ◽  
...  
Keyword(s):  
Splenic Rupture ◽  
Left Kidney ◽  
The Other ◽  
Traumatic Rupture ◽  
Target Cells ◽  
Sodium Potassium ◽  
Abdominal Organs ◽  
The Right ◽  
Rupture Of The Spleen ◽  
Previous Disease

Auto transplantation of the spleen can be performed in the patients with traumatic rupture of the spleen, in whom spleen could not be conserved in the other way. The right indication for this method is isolated rupture of the spleen (concvasation or complete devascularisation). This method is not recommended in the endangered patients, patients with previous disease of the spleen as well as in the patients with the perforation of the other abdominal organs at the same time. Auto transplantation was performed in 12 patients with isolated splenic rupture and hematoperitoneum, 11 men and one woman. The majority of patients are younger. In 8 patients, autotransplantat was placed into big omentum, in three into lipomatous tissue surrounding left kidney, and in one into anterior abdominal wall. In all the patients from this group, following analysis were taken: MCV (middle volume of erythrocytes), HTC, Hb, Le, Glucose, urea, creatinin, sodium, potassium, alkali phosphatasis, target cells, Howell Jolly's bodies, Heinz's bodies, IgG, IgA, igM, C3, C4, T3, T4, T8, B, segmentated, eosinophiles, lymphocytes, reticulocytes, thrombocytes, fibrinogen, PT, APTT, aggregation of thrombocytes and aggregation of thrombocytes on collagen. The same parameters were taken in 12 patients with surgery similar to splenectomy and in 12 after splenectomy. After splenectomy, there was decrease of the immunologic defending abilities of the organism because of the loss of the clirens function of the spleen, decreased level of the opsonines and tutsin, which leads to the impaired phagocytosis, decreased concentration of IgM and T and B lymphocytes, while in patients after auto transplantation the results were physiological. The most important thing in the assessment of the function of the autotransplantated spleen is scintigraphic investigation using 99mTc-denaturated red blood cells. In our study, auto transplant function was assessed in 10/12 patients by scintigraphy. Five years after surgery no one patient was proved to have postsplenectomic sepsis.

Unilateral renal ischaemia in the rat: Effect of method of occlusion of the blood supply on function of ipsilateral and contralateral kidneys

1987 ◽  
Vol 73 (1) ◽  
pp. 11-17 ◽  
Author(s):  
O. S. Ferwana ◽  
S. C. Pirie
Keyword(s):  
Renal Artery ◽  
Blood Supply ◽  
Left Kidney ◽  
Severe Damage ◽  
Flow Rates ◽  
Renal Ischaemia ◽  
Group 3 ◽  
Group 2 ◽  
Renal Hilus ◽  
Group 1

1. The functions of right and left kidneys were measured immediately preceding, during and for 4 h after 45 min occlusion of the blood supply to the left kidney. 2. The blood supply was occluded by placing a clamp around the renal artery near to the aorta (group 1), near to the renal hilus (group 2) or by clamping the renal pedicle after prior separation of the kidney from perirenal tissue (group 3). 3. During ischaemia right kidneys had increased urine flow rates and excretion of sodium and water, but inulin clearances (CIn) remained unchanged. 4. After ischaemia left kidneys were isosthenuric with depressed CIn. 5. Occlusion of the renal artery alone resulted in non-oliguric kidneys in which CIn was reduced to 10% and 1% respectively for groups 1 and 2. 6. The most severe damage to function was seen in the kidneys of group 3 which were oliguric and in which CIn was depressed to 0.1% of the pre-ischaemic value. 7. It is concluded that the pedicle clamp method produced complete renal ischaemia and the most severe damage to function. Occlusion of the renal artery produced incomplete ischaemia and a less severe fall in function which depended upon the site of occlusion.

scholarly journals Endothelin mediates renal vascular memory of a transient rise in perfusion pressure due to NOS inhibition

1999 ◽  
Vol 276 (4) ◽  
pp. F629-F634 ◽  
Author(s):  
Xin-Zhou Zhang ◽  
Chris Baylis
Keyword(s):  
Perfusion Pressure ◽  
Left Kidney ◽  
Renal Perfusion ◽  
Transient Increase ◽  
Transient Rise ◽  
Group 3 ◽  
Group 2 ◽  
The Right ◽  
Renal Vascular ◽  
Renal Responses

We investigated the renal responses to NO synthase (NOS) inhibition with N-monomethyl-l-arginine (l-NMA; 30 mg/kg) in anesthetized rats in which renal perfusion pressure (RPP) to the left kidney was mechanically adjusted. Acutel-NMA increased blood pressure (BP, ∼20%) and renal vascular resistance (RVR) rose (∼50%) in the right kidneys that were always exposed to high RPP. In group 1, the left kidney was exposed to a transient increase (5 min) in RPP which was then normalized, and the rise in RVR was similar to the right kidney. In group 2 the left kidney was never exposed to high RPP, and the rise in RVR was attenuated relative to the right kidney. In group 3, rats were pretreated with the endothelin (ET) receptor antagonist Bosentan, immediately before exposure of the left kidney to a transient increase in RPP, and the rise in RVR was also attenuated relative to the right kidney. NOS inhibition resulted in a natriuresis and diuresis in the right kidneys, and ∼50% of the natriuresis persisted in the left kidney of group 2, in the absence of any rise in RPP. ET antagonism completely prevented the natriuresis and diuresis in response to acutel-NMA in both left and right kidneys. These data suggest that transient exposure to high RPP by NOS inhibition prevents an appropriate vasodilatory response when RPP is lowered, due to the intrarenal action of ET.

A Delicate Balance: Religious Autonomy Rights and lgbti Rights in Australia

2015 ◽  
Vol 10 (1) ◽  
pp. 45-62 ◽  
Author(s):  
Charlotte Baines
Keyword(s):  
Legal System ◽  
Religious Freedom ◽  
Status Quo ◽  
The Other ◽  
Faith Communities ◽  
Human Right ◽  
The Status ◽  
Research Gap ◽  
The One ◽  
The Right

This article addresses a research gap by analysing the way the Australian legal system is balancing the right to religious autonomy of organisations and the right of lgbti individuals not to be discriminated against, and considers what ought to be the case. I argue that the Australian legal system recognises the value of religious freedom on the one hand, and on the other hand, does not place a high priority on protecting it as an existing human right. My findings reveal that the Australian legal system is not always defining the religion and society relationship in ways that reflect the lived reality of religion in society. The issue is compounded by the wording of religious exemptions under anti-discrimination law which is contested within faith communities. As a consequence, religious freedom can be unfairly restricted. I conclude with recommendations to improve the status quo.

scholarly journals PS70. A Contemporary Experience of Open Surgical Treatment of Renal Artery Aneurysms

2011 ◽  
Vol 53 (6) ◽  
pp. 48S ◽  
Author(s):  
Paul J. Foley ◽  
Grace J. Wang ◽  
Benjamin M. Jackson ◽  
Ali Naji ◽  
Jeffrey Carpenter ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Renal Artery ◽  
Open Surgical Treatment

scholarly journals SUPERSELECTIVE EMBOLIZATION OF THE RENAL ARTERIES AS A MONOTHERAPY OF KIDNEY TUMOR IN A PATIENT WITH HIGH ANESTHESIOLOGIC RISK

2021 ◽  
pp. 61-67
Author(s):  
V. K. Karpov ◽  
D. M. Kamalov ◽  
B. M. Shaparov ◽  
O. A. Osmanov ◽  
A. А. Kamalov
Keyword(s):  
Surgical Treatment ◽  
Renal Artery ◽  
Malignant Tumors ◽  
Left Kidney ◽  
Renal Arteries ◽  
Artery Embolization ◽  
Safe Alternative ◽  
X Ray ◽  
Superselective Embolization ◽  
Renal Artery Embolization

Introduction: Renal artery embolization is a minimally invasive X-ray endovascular operation that is used in the treatment of various urological diseases. This operation is of increasing interest due to its ability to occlude not only proximal, but also distal renal vessels with a low risk of complications. Recent developments in endovascular technology make embolization one of the effective and safe methods applicable to stop renal bleeding, preoperative preparation for surgical treatment of renal malignant tumors, and first-line treatment for angiomyolipomas. For a certain category of patients, renal artery embolization is practically no alternative method of treatment. This applies to comorbid patients with kidney tumors and aggravated somatic status, in whom the anesthetic risk makes open or laparoscopic surgical treatment impossible, and embolization can reduce symptoms, improve the quality of life of such patients and prolong the patient's life.Clinical case: we demonstrate the experience of X-ray surgical treatment of cT1aN0M0 left kidney cancer in an 80-year-old patient.Conclusion: Embolization of renal arteries in some cases can be an effective and safe alternative treatment for renal cell carcinoma in somatically burdened patients who cannot perform surgical treatment.

scholarly journals Total occlusion of the abdominal aorta in a patient with renal failure and refractory hypertension: a case report

2015 ◽  
Vol 76 (1) ◽  
Author(s):  
Cinzia Perrino ◽  
Laura Scudiero ◽  
Maria Piera Petretta ◽  
Gabriele Giacomo Schiattarella ◽  
Mario De Laurentis ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Artery ◽  
Abdominal Aorta ◽  
Left Kidney ◽  
Fatal Outcome ◽  
Left Renal Artery ◽  
Refractory Hypertension ◽  
Total Occlusion ◽  
Delay In Diagnosis ◽  
The Right

Total occlusion of the abdominal aorta is unusual, and potentially catastrophic. It occurs in patients with advanced atherosclerotic occlusive disease, and can cause severe ischemic manifestations, depending on the site of obstruction. Prompt and appropriate diagnostic and therapeutic approaches are important whenever this condition is suspected, in order to avoid a fatal outcome. The development of a complex network of collaterals may prevent the manifestation of acute ischemic phenomena, and cause a delay in diagnosis and treatment. Here we report the clinical case of a 59-year-old man who was referred to our Department for evaluation of renal failure and refractory hypertension. Ultrasonography and 99mTc-DTPA scintigraphy showed a shrunken, non-functioning left kidney, while CT angiography and aortography showed the complete occlusion of the aorta from below the right renal artery down to the bifurcation of both common iliac arteries, with a critical stenosis of the origin of the right renal artery, an occlusion of the left renal artery as well as of the origin of the inferior mesenteric artery. The patient was referred to the surgery department for aorto-bifemoral bypass surgery and re-implantation of the right renal artery.

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