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Extended nephro lithotomy under regional hypo thermia for staghorn stones

, : Extended nephro lithotomy under regional hypo thermia for staghorn stones. SMJ Singapore Medical Journal 24(1): 14-19

The technique of extended nephrolithotomy under regional hypothermia using ice-saline slush with the renal pedicle clamped was applied in operating on 28 kidneys in 25 patients with large and or multiple kidney stones, from Jan. 1970 to April 1982. There was no mortality and no kidney was lost. Morbidity includes 1 postoperative hemorrhage requiring reoperation, 1 patient developed septicemia, and 2 other patients had significant urinary tract infection and 6 developed wound infections. The incidence of residual stone is high at 50%. The possible causes are analyzed and remedial actions suggested. The importance of having good intraoperative X-ray is emphasized. Three patients are known to have recurrent stone formation. Abnormal uric acid metabolism found to be an important cause of stone formation. Of stones analyzed, 40% contained urates. The use of allopurinol may help to prevent recurrence of stones in this group of patients.

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Accession: 005432634

PMID: 6867760

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