Nofrolitotomia anatrofica simplificada
AUTOR(ES)
Lisias Nogueira Castilho
DATA DE PUBLICAÇÃO
1988
RESUMO
We describe a simplified sistematization of the anatrophic neprolithotomy technique in the treatment of 9 patients with 12 renal units with staghorn calculus, with an average age of 40 years and woman/man ratio of 3,5:1. The main changes introduced in relation to the original Smith and Boyce technique (1968) are: 1- Non-utilization of vascular injection of dyes in order to determine the limits between anterior and posterior renal segments. 2- Clamping of the whole renal pedicle. 3- Opening of all the calyceal infundibulum, stenotic or not. 4- Non-realization of calycoplasties or calyorrhaphies as an attempt to improve the intra-renal drainage. 5- Review of hemostasis after the release of the vascular clamp, prior to renal closure. 6- Non-utilization of urinary derivation. The average time of follow-up was 16 months and the final results referring to the time of surgery (average 204 min.), ischemic period (average 61 min.), blood transfusion (2 units for 9 patients), complications (22%), residual lithiasis (11%), recurrent lithiasis (zero), mortality (zero) and post-operatory stay (average 7 days) are similar to the results of other authors who practice the original technique
