A few operative procedures have been doveloped to resect a part of kidney parenchyma during the last few decades, nevertheless the partial nephrectomy still remains a difficult procedure in urologic surgery.
The authors have designed new technique which is the angular segmental resection of kidney in nephrolithiasis for the purpose of saving more functioning renal tissue, where blood supply is adequate, using long straight needle and a long number one dexon deviding into two pieces of threads to resect angular segment of the kidney. This technique is especially convenient to manage patient who has stones in polar calices.
24 consecutive angular segmental partial nephrectomies in 22 cases were performed and these cases were reviewed retrospectively from January 1st, 1980 to September 30th, 1984.
The results were as fallows.
1. The range of patient age was 20 to 60 and mean age was 43 there were 15 males and 7 females.
2. In the 22 cases of angular segmental partial nephrectomy, multiple stones were noted in 5 cases (22.7%) on the right side and 7 cases (31.8%) had on the left. Six (27.3%) cases had 7 single stone on the right side and in 2 cases on the left while 2 cases had bilateral multiple stones.
3. The indication of angular segmental partial nephrectomy was calyceal single or multiple stones in 24 kidneys.
4. Of the 24 angular segmental partial nephrectomies, lower poles were removed in 19 kidneys, midcalyces were removed in 2 kidneys and upper poles were removed in 3 kidneys.
5. Histopathological studies of resected specimen in 24 kidneys were performed and mid portion of resected pieces showed much more severe pathologic changes such as atrophy, hyalinization, degeneration and cellular infiltration than specimens taken from peripheral region.
6. Normal excretory urographic findings except resected area of kidney were obtained, in follow up studies one to two months after surgery.
7. Microscopic hematuria and pyuria were mostly ceascl in follow up studies in tw weeks after the angular segmental resection of the kidney.
8. Nephrostomy tube was not used.
9. One case of urinary fistula was seen and nephrectomy was performed one month after the partial nephrectomy.
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