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Complete longitudinal nephrolithotomy for staghorn calculi in children
ABSTRACTS Simple Renal Cysts in Childhood. S. Ahmed. Brit. J. Urol. 44:71-75 (February), 1972. Two girls, aged 6 wk and 9 yr, presented with an abdominal mass. In each case the lesion was a simple unilocular renal cyst involving the upper pole of one kidney. Cystectomy was performed with good result. -7. H. 7ohnston Complete Longitudinal Nephrolithotomy For Staghorn Calculi In Children. R. G. Middleton and V. F. Marshall. J. Urol. 166:77&779 (November), 1971. Three cases are presented in which successful removal of large staghorn calculi was carried out using a complete longitudinal split of the kidney bilaterally in two children, and of one half of one kidney in a third. The authors’ technique includes renal artery occlusion, stone removal, meticulous of kidney hemostasis, reapproximation halves by closure of capsule only, two nephrostomy tubes, an x-ray prior to leaving the operating room, and a low-phosphorus diet. Followup in two cases of 3% and 12 yr shows no recurrence.-S. Kim Survival After Right Nephrectomy, Excision of lnfrahepatic Vena Cava and Ligation of Left Renal Vein: A Case Report. 1. C. Pathak. J. Ural. X6:599-602 (October), 1971. This is a case report of a 3%yr-old girl with a right-sided Wilms’ tumor. During surgery a portion of the vena cava was excised and the left renal vein was ligated. The patient died 6 mo following surgery of widespread metastatic disease.-S. Kim Arterial Changes Associated with Hydronephrosis in Infants and Children. M. H. Winterborn and N. E. France. Brit. J. Urol. 4496-164 (February), 1972. Sixty-three kidneys with hydronephrosis of various grades of severity and of various causation were studied histologically. The ages of the patients ranged from birth to 14 yr. In the majority, arterial damage was apparent in the interlobular and arcuate arteries; this consisted of intimal elastic cushions and breaks in the internal elastic
461 lamina. The changes were commoner in the more severely hydronephrotic kidneys and the elastic cushions appeared larger with inage. The arterial lesions are creasing thought to result from increased pressure in the urinary tract resulting from obstruction or reflux. It is suggested that the arterial damage may predispose to atherosclerosis and subsequent renal hypertension. -7. H. 7oknston Hydronephrosis due to Pelvi-ureteric Obstruction in Children. An Assessment of the Anterior Transperitoneal Approach. H. B. Eckstein and 1. Kamal. Brit. J. Surg. 56:663-667 (September), 1971. Twenty-four children with hydronephrosis due to pelviureteric obstruction are reviewed. Five of these were bilateral, for a total of 29 kidneys. The anterior transperitoneal approach is recommended because of the ease of access, which makes it unnecessary to mobilize the kidney from its bed. The types of operation performed were two nephrectomies for very severe hydronephrosis, four Y-V plasties of the pelviureteric junction, and 23 Hynes-Anderson pyeloplasties. Conservative surgery is recommended as there is a danger of the opposite kidney becoming hydronephrotic later in life. The results are difficult to assess and by radiological assessment they are disappointing. Out of 27 kidneys (two nephrectomies), 11 showed radiological improvement, nine showed no change, six were too early to assess, and one was not known. However, rapid filling and visualization of the ureters after surgery denotes success even if the calyces are unchanged. Assessment in symptomatic relief is much more rewarding. All but one child were relieved of their symptoms. The one case developed recurrent urinary infection leading to stricture of the anastomosis with stone formation. This child had a repeat pyeloplasty and his progress has been satisfactory. At the time of the review no cases developed hypertension. -7. Lari Ureteropelvic Junction Obstruction in Children: Experiences with 109 Cases. P. P. Kelalis, 0. S. Gulp, G. B. Stickler, and E. C. Burke. J. Urol. lW416-422 (September), 1971.
461 lamina. The changes were commoner in the more severely hydronephrotic kidneys and the elastic cushions appeared larger with inage. The arterial lesions are creasing thought to result from increased pressure in the urinary tract resulting from obstruction or reflux. It is suggested that the arterial damage may predispose to atherosclerosis and subsequent renal hypertension. -7. H. 7oknston Hydronephrosis due to Pelvi-ureteric Obstruction in Children. An Assessment of the Anterior Transperitoneal Approach. H. B. Eckstein and 1. Kamal. Brit. J. Surg. 56:663-667 (September), 1971. Twenty-four children with hydronephrosis due to pelviureteric obstruction are reviewed. Five of these were bilateral, for a total of 29 kidneys. The anterior transperitoneal approach is recommended because of the ease of access, which makes it unnecessary to mobilize the kidney from its bed. The types of operation performed were two nephrectomies for very severe hydronephrosis, four Y-V plasties of the pelviureteric junction, and 23 Hynes-Anderson pyeloplasties. Conservative surgery is recommended as there is a danger of the opposite kidney becoming hydronephrotic later in life. The results are difficult to assess and by radiological assessment they are disappointing. Out of 27 kidneys (two nephrectomies), 11 showed radiological improvement, nine showed no change, six were too early to assess, and one was not known. However, rapid filling and visualization of the ureters after surgery denotes success even if the calyces are unchanged. Assessment in symptomatic relief is much more rewarding. All but one child were relieved of their symptoms. The one case developed recurrent urinary infection leading to stricture of the anastomosis with stone formation. This child had a repeat pyeloplasty and his progress has been satisfactory. At the time of the review no cases developed hypertension. -7. Lari Ureteropelvic Junction Obstruction in Children: Experiences with 109 Cases. P. P. Kelalis, 0. S. Gulp, G. B. Stickler, and E. C. Burke. J. Urol. lW416-422 (September), 1971.