腎結石手術中 止血에 관한 硏究 = A Study on Bleeding Control in Conservative Renal Surgery for Renal Calculi

다국어 초록 (Multilingual Abstract)

Surgery for the renal calculi is one of the most frequently performed operations in the field of urology.
An extended pyelolithotomy has been well established and popularized by Gil-Vernet since 1965. However, it has been occasionally found to have a profuse bleeding from the renal parenchyma secondary to an injury made during procedure of removing the stones which deeply impacted in the calicies, since blood supply to the kidneys is about 25% of total cardiac output.
Therefore, sometimes, the bleeding control is very difficult, and nephrectomy is occasionally performed.
Pyelolithotomy was done in 20 cases whom bleed considerably, and we used a renal artery clamp or a renal pedicle clamp in order to stop bleeding and applied with a clamp which remain clamped from 3 minutes up to 18 minutes period of time. The result with the clamp for hemostasis was excellent in all cases.
Most of the cases were required 3 minutes of clamp to stop bleeding, and one case was required 18 minutes which was the longest time required for it.
We also applied the same method with the clamp in 14 cases of partial nephrectomy patients and used divided intrarenal mass ligation technique for the purpose of postligation hemostasis and excellent results were also obtained in all 14 cases.
By using this method, the maximum effort was easily made to remove all fragments of the stone without a fear of having heavy bleeding.