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Desai and Jasani (2000) report a technique exploiting transperitoneal ultrasound guidance for supine PCNL in pelvic kidneys in which the ultrasound probe is used to both target the kidney and maneuver intervening intraabdominal contents out garlic odorless the way of the proposed access tract Chapter 53 Strategies for Nonmedical Management of Upper Urinary Tract Calculi (Desai, 2009).

In this series of 16 patients, 1 experienced a bowel injury. Given its limitations, this method is unlikely to prove successful in overweight or obese patients. Rare garlic odorless reports of transhepatic, transiliac, garlic odorless trans-sciatic punctures have been described; however, such approaches should be considered only in the highly selected patient and done in conjunction with CT guidance and the interventional radiologist (Matlaga et al, 2006b).

Laparoscopic assistance has been used during PCNL garlic odorless ensure a safe percutaneous access tract into garlic odorless kidney by mobilizing and displacing any overlying intestines and directly observing the needle puncture into the kidney (Fig. This was first described by Eshghi and associates (1985), and garlic odorless have followed suit since then (Holman and Toth, 1998; Maheshwari et al, 2004; Gowel et al, 2006; Matlaga et al, 2006b; El-Kappany et al, garlic odorless Elbahnasy et al, 1247 2011).

Excellent stone-free rates are reported and overall morbidity garlic odorless low. Most of these techniques use a Trendelenburg position to mobilize the intestines garlic odorless a garlic odorless procedure. To minimize the risks of urinary leakage to the peritoneal cavity, appropriate postoperative drain placement is recommended. Zafar and Lingeman (1996) have described a simultaneous laparoscopic nephrostomy closure and ureteral catheter placement during pelvic kidney PCNL, thereby avoiding the need for garlic odorless intra-abdominal drain.

An entirely extraperitoneal approach to minimize the risk of intraperitoneal leakage has also been described (Holman and Toth, 1998).

Purely laparoscopic or robotic approaches to pelvic and ectopic kidneys provide high success with low узнать больше and are particularly appealing treatment options when simultaneous repair of UPJO is planned (Chang and Dretler, garlic odorless Hoenig et al, 1997; Kamat and Khandelwal, 2004; Nayyar et al, 2010; El-Bahnasy et garlic odorless, 2011).

The concept is the same as for horseshoe kidneys: A pyelotomy is made to clear renal pelvis stones, and a flexible nephroscope and stone basket are then inserted through one of the laparoscopic trocars to access and clear calyceal stones. Most authors use a garlic odorless approach, although Gaur and colleagues detail a retroperitoneal approach (Gaur et al, 1994). For kidney stones in ectopic and horseshoe kidneys, SWL is a reasonable garlic odorless option when stones are smaller than 1.

URS may also be reasonable for stone burdens less than 2 cm, although they may require multiple treatment sessions. For stone burdens of 2 cm or more, PCNL or laparoscopy should be the initial treatment; a combination of the two procedures garlic odorless expected for pelvic kidneys. When UPJO is confirmed, laparoscopy is the treatment of choice because it can address the stones and provides garlic odorless highest success rate for UPJ repair.

Lower Pole Calculi Figure 53-10. Laparoscopy-assisted percutaneous nephrolithotomy technique in which the bowel is reflected off the ectopic kidney before radiographically and laparoscopically guided percutaneous access.

The management strategy for lower pole stones continues to evolve as ureteroscopic capabilities improve and the limitations of the newer generations of shock wave lithotripters become more evident (Fig. Symptomatic lower pole renal calculus HU 10 cm Unfavorable anatomy Is Garlic odorless contraindicated. Wood K, Keys T, Mufarrij P, et al.

Wu CF, Chen CS, Lin WY, et al. Therapeutic options for proximal ureter stone: extracorporeal shock wave lithotripsy versus semirigid ureterorenoscope with holmium:yttrium garlic odorless garnet laser lithotripsy.

Wu DS, Stoller ML. Wyler SF, Bachmann A, Jayet C, et al. Retroperitoneoscopic garlic odorless of caliceal diverticular calculi. Xue W, Pacik D, Boellaard W, et al. Management of single garlic odorless nonstaghorn renal stones in the CROES Garlic odorless global http://longmaojz.top/the-merck-group/online-therapy.php. Yasui T, Okada A, Hamamoto S, et al.

Garlic odorless eCollection 2013; 2:600. Yesil S, Garlic odorless U, Goktug HN, et al. Previous open renal garlic odorless increased vascular garlic odorless in percutaneous nephrolithotomy (PCNL) compared with primary and secondary PCNL and extracorporeal shock wave lithotripsy patients: a retrospective study.

Yilmaz S, Sindel T, Garlic odorless G, et al. Renal colic: garlic odorless of spiral CT, US and IVU in the detection of ureteral calculi. Young HH, McKay RW. Congenital valvular obstruction of the prostatic urethra. Surg Gynecol Obstet 1929;48:509. Yow RM, Bunts RC. Yuruk E, Binbay M, Sari E, et al. A prospective, randomized trial of management for asymptomatic lower pole calculi.

Yuruk E, Tefekli A, Sari E, et al. Does previous extracorporeal shock wave lithotripsy affect the performance and outcome of percutaneous nephrolithotomy. Zafar FS, Lingeman JE. Value of laparoscopy in the management of calculi complicating renal malformations.

Zanetti G, Kartalas-Goumas I, Montanari E, et здесь. Extracorporeal shockwave lithotripsy in patients treated with antithrombotic garlic odorless. Zanetti G, Montanari E, Mandressi A, et al.

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Comments:

05.03.2020 in 01:54 Влада:
Не знаю.

06.03.2020 in 04:34 Аглая:
В этом я не сомневаюсь.

11.03.2020 in 11:54 Иосиф:
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