[Contact renal refrigeration with continuous control of the intrarenal temperature in surgery for staghorn calculi].
Surgical treatment of staghorn calculi is a meticulous, difficult, and time-consuming procedure which requires the taking of contact films during operation. Incision of the renal parenchyma is frequently also necessary. To limit blood loss, and mainly in order to have a clear field of view, intrarenal blood circulation has to be interrupted by clamping the renal pedicle. This circulatory arrest can be supported for only 20 minutes, without major risks to the renal parenchyma, under normal temperature conditions. However, at least in the authors' hands, more than 10 minutes are necessary between the taking of the contact film and its return after development to the operation room. In contrast, lowering renal temperature by 10 to 20 degrees C enables ischemia to be maintained for up to 4 hours without adverse consequences. Contact refrigeration of the kidney by surrounding it with crushed ice is used, permanent control of temperature being maintained by a thermocouple linked to a continuous digital display. This simple, easy to install method does not require high investments or sophisticated material. It has enabled continuous clamping to be applied for periods of up to nearly 2 hours, with normal follow-up I.V.P. one week later.
D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D007669:Kidney Calculi / Q000601:surgery*; D012079:Renal Circulation; D013696:Temperature; D013997:Time Factors
La réfrigération rénale de contact sous contrôle permanent de la température intra-rénale dans la chirurgie de la lithiase coralliforme.