[Development of nephrectomy during the nineteenth century and its introduction into Spain].
OBJECTIVE
After first nephrectomy lumbar made by Dr. Simon in 1869, the surgical technique was established and the procedure access was followed by several surgeons with initial controversy between the use of the intra or extraperitoneal access. We carried out a review about the evolution of this surgical procedure among XIX century and of those who were pioneers with this Kind of technique in our country.


METHODS
We have reviewed books of history of the Urology, the chapters of surgery in classic urology volumes and the oral presentations to the Spanish Medical congresses, until beginning of XX century and the published nephrectomy procedures in medical literature of that time.


RESULTS
We analyzed different statistical studies appeared at the time about results of the operation, the decrease of mortality in the nephrectomies made by extraperitoneal access demonstrated its advantage soon. We found out 35 kidney removal performing the lumbar access, carried out in Spain in the last third of the XX century, three by Dr Federico Rubio and Gall in Madrid, in Barcelona by the urologist Dr. Victor Azcárreta Colán and Jose Pages and by the surgeons Drs. Esquerdo and Salvador Cardinal, from Sevilla, Dr Antonio Solano and the canary urologist Dr. Jose Hernández Perez, who were pioneers performing this procedure in our country.


CONCLUSIONS
The introduction of nephrectomy by lumbar access in Spain was delayed in relation to the rest of Europe, due to the secular delay that we dragged, only when adequate conditions of the operating rooms, as much as anaesthesia and asepsis and surgical devices tools, guaranteed the success operation, the main surgeon begun to perform it.
Albacete
Pérez M
PM
Servicio de Urología, Hospital Universitario Virgen de la Arrixaca, Murcia. mariano.perez2@carm.es
Ruiz
Tornero J
TJ
Cubillana
López P
LP
D049672:History, 19th Century; D009392:Nephrectomy / Q000266:history*; D013030:Spain