珊瑚状結石およびそれに類する腎結石の手術に関する臨床的研究(1)
1972 年 63 巻 10 号 p. 809-832
詳細
1972 年 63 巻 10 号 p. 809-832
The author made a study on the renal function before and after operation of staghorn calculi and similar renal stones in 27 kidneys of 25 patients. The cases were divided into the following three groups: Group I (10 kidneys) were subjected to nephrolithotomy (N-L) with clamping (including 2 kidneys in which extended pyelolithotomy (E-P) was also employed). Group II (14 kidneys) were subjected to E-P without clamping. Group III (3 kidneys) were subjected to N-L and E-P without clamping. Renal clearance (GFR, RPF), serum and urinary electrolytes, Fishberg's concentration (Fishberg), isotope renogram, intra-venous pyelography (IVP) and their correlations were studied.
The following conclusions were obtained.
1) Disappearance of gross hematuria was earlier in Group II than in Groups I and III.
2) Postoperative recovery of renal function was earlier and more complete in Groups II and III than in Group I.
3) As to the total renal function after operation, there was a tendency that GFR was more improved than RPF in all of the three Groups.
4) The postoperative decrease of the urinary volume in the contra-lateral non-operated kidney was observed in Group I. On the other hand, this phenomenon was not found in Groups II and III.
From the results mentioned above, the author is of the opinion that the extended pyelolithotomy is the best operation for almost all patients with staghorn calculi of the kidney.
