Abstract
Peritoneal irrigation has been recognized as a treatment to compensate renal function in acute anuria. This method was first devised by Ganter (1923) and developed by others. Odel has reviewed the results from 101 clinical cases.
Recent development of surgical approach to the kidney made it possible to perform partial nephrectomy. This would be done without any trouble in the case with bilateral kidney. However, considerable caution should be employed in the case with unilateral kidney, because of the occurrence of anuria resulting from disturbance of the renal blood supply by operative procedures.
In the present study peritoneal irrigation was applied as overcoming temporary anuria due to partial nophrectomy. The results obtained were as follows;
1) When peritoneal irrigation was used, experimental rabbits survived more than one year after the resection of 72 to 73% of the unilateral kidney.
2) Partial nephrectomy was tried clinically in 5 patients with unilateral kidney. The following portion of the kidney was excised: one, 1/3 of the center; one, 1/2 of the lower pole; three, 1/3 of the upper or lower pole. All patients have now lived several years postoperatively having normal range of N. P. N. and blood electrolytes.
3) Peritoneal irrigation was employed in one case of anuria followed by blood transfusion of different type. It was started at the 4th day of anuria and stopped at the 6th day of irrigation by the request of the family. The patient died next day. Another one was anuria which appeared to be due to food intoxication. Irrigation was started at the 7th day. Urinary excretion began at the second day of irrigation and the patient recovered.
4) The rational irrigating solution was prepared considering composition of serum of the patients. An adequate velocity of irrigating and temperature of fluid were established.
