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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Laparoscopic surgery has been widely performed for removing the gallbladder and the pelvic lymph-nodes in recent years. We have applied laparoscopy technique to nephrectomy and here we describe our procedures and the clinical results. The patient is placed in the supine position under general anesthesia. After a 4 liter CO2 pneumoperitoneum is induced, five trocars are inserted into the abdominal cavity through the ipsilateral abdominal wall. The patient is then turned to the lateral position to displace the bowel medially. The ipsilateral colon is reflected medially after incision of the parietal peritoneum was made along the line of Todt to expose the retroperitoneum. The ureter was identified and dissected. It was secured with 4 clips (2 clips on the renal side and 2 on the distal side) and then cut with scissors. The renal vein and artery were then dissected and separately ligated with clips as described above. These vessels were also cut. The upper pole of the kidney was dissected out and the adrenal gland was left in place. The kidney thus became completely free within the abdomen. It was then grasped by the forceps through a 10 mm sheath positioned below the umbilicus. After incising the abdominal wall, the kidney was removed from the abdominal cavity with the grasping forceps and the sheath. By this procedure right nephrectomy was completely performed in a 56-year-old female patient and left nephrectomy in a 56-year-old male patient. The underlying disease was recurrent pyelonephritis secondary to renal calculi in both cases. The operative times were 221 min and 346 min, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Laparoscopic nephrectomy. Preliminary report]. 153 98

The authors observed 812 patients with nephrolithiasis who underwent 876 sessions of shock-wave lithotripsy on Sonolith-3000 lithotriptor supplied with an ultrasonic system of the stone localization. The size of nephroliths ranged from 0.7 to 4.2 cm. Large-size nephroliths required repeated sessions and pretreatment establishment of the stent. The procedure proceeded without anesthesia. Subsequent renal colic was reported in 126 (15.5%), an exacerbation of pyelonephritis in 45 (5.5%), subcapsular hematoma in 4 (0.5%) of the patients. 790 patients showed clinical response (97.3%), with a complete destruction of the stone in 446 (54.9%) and partial one in 344 (42.4%) cases. 27 subjects were treated in outpatient setting. According to the authors, lithotripsy is contraindicated in urinary tract obstruction below the stone, renal failure, chronic pyelonephritis in the active phase of inflammation, marked impairment of cardiac rhythm.
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PMID:[Extracorporeal shockwave lithotripsy on the Sonolith-3000 apparatus]. 175 17

Thirty patients with partial of total staghorn calculi or pyelic calculi greater than 30 mm were treated by extracorporal piezo-electric lithotripsy (PEL) exclusively with an EDAP LT 01 lithotripter equipped with an ultrasound localisation system. Nineteen patients had a pyelic calculus and the others a partial (n = 9) or total (n = 2) staghorn calculus. All patients first underwent extracorporal lithotripsy (ECL). None of the patients received IV sedation or anesthesia. When fragmentation of the calculus was observed after the first session, a double J stent was inserted before the second ELC session. Before the first session, urine samples were sterile in 18 of the 30 patients; 12 of the 30 patients presented major distention of the urinary tract. Results were analysed to identify factors affecting results of this type of treatment. Patients whose calculus had completely disappeared on plain films three months after the first session were considered to be cured clinically and radiologically (14/30 = 46%). Seven patients (23.3%) were clinically cured (absence of pain and sterile urine) but there were residual fragments (1 to 3 fragments less than or equal to 4 mm). No fragmentation was obtained after the first session in 9 patients (30.7%) (1 total staghorn, 8 pyelic calculi). The mean number of sessions was 5 (range 1-15). Only 10% of the patients (3/30) presented a complication: 2 steinstrasses and 1 acute pyelonephritis. 83% of the patients without urinary tract distention and 55% of the patients whose urines were initially sterile were cured.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Exclusive piezo-electric lithotripsy (EDAP LT 01) in the treatment of calculi larger than 30 mm. Pyelic, partial or total staghorn]. 207 30

Thirty patients with partial or total staghorn stones or calculi larger than 30 mm were treated by piezoelectric lithotripsy (PEL) monotherapy using an EDAP LT-01 lithotripter with ultrasound guidance. Nineteen of these patients had pelvic stones; the other 11 had partial (9) or total (2) staghorn stones. All patients first underwent an initial lithotripsy session. No anesthesia or IV sedation was required in any case. If stone fragmentation was achieved during this first session, a double-J stent was inserted before the second lithotripsy session. Prior to the first session, 18 of 30 patients had sterile urine cultures; 12 of 30 presented major distension of the excretory tract. Results were analyzed to determine the factors influencing the outcome of this therapy. Three months after the first session, patients were considered cured if their stones had completely disappeared according to plain abdominal films (14 of 30, 46%). In seven patients (23.3%) fragmentation had occurred but residual fragments remained (1 to 3 fragments less than or equal to 4 mm). No fragmentation was obtained after the first session in nine patients (30.7%) (1 total staghorn stone, 8 pelvic stones). The mean number of treatment sessions was five (range, 1 to 15). Complications occurred in only 10% of patients (3 of 30): two steinstrassen and one acute pyelonephritis. Eighty-three percent of patients without major excretory tract distension and 55% of patients whose initial urine culture was sterile achieved a stone-free state. Therefore the best indications for PEL monotherapy for calculi larger than 30 mm are pelvic stones and partial staghorn stones and no major excretory tract dilatation in patients with sterile initial urine cultures.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Exclusive piezoelectric lithotripsy in the treatment of calculi larger than 30 mm (partial or complete coralliform, pyelic calculi)]. 222 37

Clinical experience with 2738 patients treated by extracorporeal shock wave lithotripsy between March 1985 and December 1988 is reported. All treatments were performed with the Dornier HM-3 lithotriptor. 34% of the patients needed auxiliary measures, consisting primarily of urological manipulation to improve urinary drainage or for better localization and/or focussing of the stones. Severe complications were rare; urosepticemia occurred in 0.3%, 2 patients had to undergo nephrectomy because of abscessing pyelonephritis, and there was one death due to recurrent pulmonary embolism in a patient with polycythemia vera. ESWL was used for stones in the entire upper urinary tract. The stone free rate for pelvic calculi smaller than 2 cm was 79% three months after treatment; a further 16% showed desintegrated material smaller than 5 mm, augmenting the success rate to 95%. The success rate dropped to 74% for very large renal stones of more than 4 cm. A stone free rate of 84-96% was ascertained for ureteral calculi 3 months after ESWL. Absolute contraindications for ESWL are acute pyelonephritis, coagulation disorders and pregnancy. The patients must tolerate anesthesia, as most treatments with this lithotriptor must be carried out under peridural or general anesthesia and only in a few exceptional cases is treatment in sedoanalgesia possible. ESWL is now generally accepted in view of its negligible invasiveness, low morbidity and the high success rate. Modern treatment of urinary calculi is inconceivable without considering ESWL.
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PMID:[Clinical experiences with extracorporeal shockwave lithotripsy]. 279 24

A 32-year-old female consulted our hospital with the complaint of recurrent urinary tract infections, especially acute pyelonephritis. Cystoscopy revealed a wide-based tumor covered with a normal epithelium at internal meatus and right slight opened orifice, the contraction of which was slightly weak. Excretory urography showed almost normal nephrogram, pyelogram and ureterogram, and voiding cystography revealed right vesicoureteral reflux with grade IIb. Under general anesthesia, tumor resection of the bladder and right ureterovesiconeostomy were carried out. Pathologically the tumor was diagnosed leiomyoma. Right vesicoureteral reflux was speculated to have occurred secondarily to leiomyoma of the urinary bladder.
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PMID:[Leiomyoma of the urinary bladder associated with right vesicoureteral reflux]. 304 78

Ureterocolonic anastomosis (UCA) was performed in 10 dogs with transitional cell carcinoma of the urinary bladder trigone or the urethra, or both. All grossly visible tumor was excised. All of the dogs recovered from anesthesia and surgery and had anal continence with no urine leakage. One dog died of undetermined causes 7 days after surgery. Nine dogs survived 1 to 5 months. The owners of eight of the dogs considered their dog's quality of life to be acceptable. Four dogs were euthanatized because of neurologic disease, three of which also had nausea and vomiting. The neurologic and gastrointestinal signs may have been caused by hyperammonemia, metabolic acidosis, and uremia. Blood ammonia levels were elevated in two dogs with neurologic signs. Hyperchloremic metabolic acidosis that was reversible with bicarbonate therapy was diagnosed in five dogs. All of the dogs were azotemic because of intestinal recycling of urea. Serum creatinine concentrations increased in four dogs after surgery. Drug-induced renal disease may have developed in two dogs. Pyelonephritis developed in five kidneys, two of which had outflow obstruction and two had bilateral hydroureteronephrosis before the UCA. In this small number of dogs, surgical excision of transitional cell carcinoma was not curative with six dogs having confirmed metastatic lesions at the time of death.
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PMID:Ureterocolonic anastomosis in ten dogs with transitional cell carcinoma. 323 87

Using a percutaneous approach, 18 of 20 staghorn calculi were completely removed from the upper urinary tract. The initial nephrostomy was performed in the radiology department with local anesthesia. Tract dilatation and stone removal ensued on the next day in the operating room under general anesthesia. Minor complications, including postoperative temperature spikes and pyelonephritis, occurred in seven patients. Two major complications, urosepsis and hemorrhage requiring transfusion, were encountered.
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PMID:Percutaneous removal of renal staghorn calculi. 387 1

Percutaneous nephrostomy can provide rapid relief of renal failure due to ureteral obstruction by contiguous spread of cervical malignancy. A series of 26 percutaneous nephrostomies placed in 14 patients with cervical cancer, using only local anesthesia and ultrasound or fluoroscopic guidance is presented. Twelve patients experienced no complications, one developed pyelonephritis which cleared rapidly with antibiotics, and one suffered a hematoma managed by surgical nephrostomy. Three of six previously untreated patients and one of eight patients with recurrent disease survived over a year. A single exenterated patient was stented when anuria developed after surgery to correct a conduit leak. This patient survives at 1.5 years with no evidence of recurrence. Indications for percutaneous nephrostomy, anticipated benefits, and the decision-making process involved in determining who to stent is reviewed.
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PMID:The role of percutaneous nephrostomy in gynecologic oncology. 665 81

The nonionic radioopaque ultravist and the high-molar radioopaque verograffin were studied for their effects on the blood osmotic status of children with lower renal concentrating function. A total of 36 children aged 8 months to 12 years who had pyelonephritis, hydronephrosis and renal injury at their acute stage were studied angiographically under general anesthesia. The radioopaque was injected in a mean dose of 2 ml/kg for 2-3 sec. Ultravist was found to have a less osmotic action on the blood osmotic status than did verograffin. The changes in the detectable major blood osmotic parameters: sodium, potassium, glucose, urea, creatine were less pronounced. Plasma osmolality was moderately increased with ultravist and much higher than its normal values with verograffin at min 1 after its administration and at hour 2 of the study. Ultravist is preferable as a radiopaque used in children with decreased renal concentrating function.
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PMID:[Ultravist - drug of choice for radioopaque studies in children with renal disfunction]. 751 23


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