F. Rovera

Laparoscopic renal cyst excision

SummaryRenal cystic failure generally does not require any form of treatment except in cases where a secondary obstruction of the excreting tract occurs, for persistent hypertension, when symptomatic pain persists or is complicated by infection or haemorrhage. Laparoscopic treatment of a renal cyst has proved to be a safe and efficacious therapy. We report our transperitoneal and retroperi-toneal experience with laparoscopic resection of simple renal cysts, between January 1992 and June 1995. We employed a transperitoneal approach for 10 patients and in eight cases a retroperitoneal access. No intraoperative complications were encountered in this series. In all patients blood loss was less than 100cc. With both approaches patients can be discharged between 24 and 72 h after the operation. At 6 month follow up, one recurrence was observed in the group of patients treated transperitoneally. Retroperitoneoscopy seems to be safer and easier compared to the transperitoneal technique.

Prophylactic Treatment of Recurrent Calcium Stones with Potassium Sodium Citrate

Recently, several workers using treatment with alkaline citrate, either as potassium citrate or as potassium sodium citrate, have reported the control of stone formation in the majority of patients1.

Laparoscopic treatment of renal cysts

Four patients underwent laparoscopic resection of extensive (8–15 cm) inferior and medio-renal polar cysts of the kidney. The average operating time was 2 h. The operation is performed with the patients lying in a lateral decubitus position, and requires four incisions for access. The laparoscopic resection of renal cysts can be proposed as a valid alternative to standard surgical treatment as well as percutaneous hollow-needle aspiration.

Long-Term Results of Extracorporeal Shock Wave Lithotripsy, Percutaneous Nephrolithotomy and Open Surgery for Upper Urinary Tract Stone

By the early 1980s percutaneous nephrolithotomy (PCNL) and extracorporeal shock wave lithotripsy (ESWL) had gained favour over open surgery. In particular, ESWL has become the operation of choice in the management of renal stones. The indications for ESWL have been extended to include the treatment of almost all renal stones1. It has also been claimed that ESWL in combination with PCNL should be the standard treatment of large volume staghorn stones2. The short term results of new techniques compare favourably with the operative series3-6. In contrast, there have been few investigations to determine the frequency of long term recurrences after ESWL and/or PCNL7-9. The incidence of late recurrence of stone following extracorporeal, endourological and open treatment is described and discussed.

ATP Depletion: A Possible Role in the Pathogenesis of Uric Acid Nephrolithiasis in the Elderly

Undue acidity of the urine attributed to a deficiency in renal ammoniogenesis has been claimed to be prevalent in certain groups of patients who may form uric acid stones even in the absence of hyperuricosuria1.

Urinary Tract Stone After Ureterosigmoidostomy

Patients with urinary diversion have an increased risk of forming renal calculi. The incidence of renal stones after ureterosigmoidostomy (USS) increases with the length of follow up and varies in different series from 8 to l8%1. Renal calculi after urinary diversion are attributed to stasis and chronic infection, but the presence of metabolic complications may increase the risk of forming renal calculi.

Inhibitors of Urinary Stone Formation in Controls and Stone Formers

Citrate, magnesium and zinc are known to be powerful inhibitors of crystal formation while glycosaminoglycans (GAGs) and citrate are effective inhibitors for crystal aggregation1.

Experimental laparoscopic nephroureterectomy: technical operative steps

SummaryTen male domestic pigs were subjected to laparoscopic nephroureterectomy. The procedure entailed only minimal loss of blood. The renal pedicle was resected using Endo-GIA equipment. A bladder cuff was obtained using an Endo-GIA stapler, which allowed the progressive reduction of the operating time from an initial 120 min to around 60min.