
Nefrectomía parcial en la patología litiásica
NICOLÁS ALBERTO CRUZ GUERRA, ENRIQUE GARCÍA CUERPO, JUAN LUIS SANZ MIGUELÁÑEZ, JAVIER SÁENZ MEDINA, BERNABÉ POZO MENGUAL, FRANCISCO LOVACO CASTELLANO
Nefrectomía parcial en la patología litiásica
OBJECTIVE: To analyze our series ofpatients with renal lithiasis who underwent partialnephrectomy from 1980-1999.METHODS: 28 patients who underwent partialnephrectomy were analyzed (22 females; mean age 48.09years, and 6 males; mean age 60 years). Surgery forlithiasis had been previously performed in 5 renal units.Nine patients had previously undergone ESWL (more than3 sessions), all of whom subsequently developed multipleresidual calculi. Twelve patients had a microbiologicallyconfirmed positive urine culture. The renal lithiasisamenable to treatment by partial nephrectomy wasfrequently localized in the lower calyces (17 cases).RESULTS: Histopathological analysis of thenephrectomy specimen showed a prevalence of signs ofchronic parenchymal atrophy (25 cases). Three casesshowed segmental renal dysplasia (those in whom asuperior heminephrectomy was performed for duplexexcretory system). Fifty percent of the stone fragmentsanalyzed showed calcium phosphocarbonate. Eightpatients had postoperative complications; the mostimportant were two cases of renal cutaneous fistula andone subphrenic abscess.At 91/2 years' mean follow-up, renal function is normalin 25 patients. Lithiasis developed in the contralateralunit in 6 cases and in the same renal unit in one case.CONCLUSIONS: Partial nephrectomy continues to bea therapeutic option for lithiasis. Its indication depends onthe morphological and functional characteristics of thecompromised renal unit, especially in those cases in whomrenal preservation can be obviated due to its scantysignificance.
Kidney / Lithiasis / Partial nephrectomy {{custom_keyword}} /
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