Coagulum pyelolithotomy: impact on unrecognized stones.
The use of coagulum free of thrombin to remove 313 renal calculi from 46 patients is reviewed. Twenty-six additional calculi removed from 17 patients were not apparent on preoperative studies. Of the 313 stones apparent preoperatively 3 were not extracted in the coagulum. Other means (stone forceps and so forth) were used to deliver 2 of these calculi and 1 was left in the kidney. Incisions used for these procedures included the conventional flank incision in 9 patients, a 10 cm. posterior flank incision in 30 and lumbotomy in 7. Adjunctive use of coagulum in 8 additional patients is presented. The recovery of more than the preoperatively identified renal calculi may be an advantage for coagulum pyelolithotomy. The length of hospital stay in these 46 patients averaged 4.8 days, with an average operative time of 1.22 hours. The patients returned to work within an average of 13 days. We suggest that these data are comparable to other methods of pyelonephrolithotomy.
D005169:Factor VIII / Q000627:therapeutic use*; D005340:Fibrinogen / Q000627:therapeutic use*; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery / Q000628:therapy*; D007902:Length of Stay; D013997:Time Factors
C026912:cryoprecipitate coagulum; D005169:Factor VIII; D005340:Fibrinogen