By Anders Hartmann, Per Fauchald (auth.), Inge B. Brekke MD, PhD, Audun Flatmark MD, PhD (eds.)
The topic of this publication is salvage of kidney functionality in sufferers with numerous surgically correctable issues affecting one or either kidneys. Preoperative work-up, and surgical and postoperative administration are defined intimately. the point of interest is on tools of bench surgical procedure and next autotransplantation of the kidney(s) in addition to the applicability and ideal result of those tactics. many of the suggestions are good illustrated through drawings and X-rays. Physicians of some of the disciplines will research that renal autotransplantation will be thought of in sufferers struggling with renovascular high blood pressure, renal melanoma, and intricate urinary calculous ailment, or different complicated renal/ureteral problems: for instance, extracorporeal surgical procedure and autotransplantation bargains optimum stipulations for renovascular reconstruction. The strategy presents first-class long term leads to the therapy of recurrent nephrolithiasis and ureteral lesions, and represents a sound substitute to nephrectomy and dialysis therapy in sufferers with renal carcinoma.
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Additional resources for Extracorporeal Renal Surgery and Autotransplantation
However, the time to peak activity and Tl/2 usually suffice, provided visual evaluation of sequential images is included. When there is a delay in the start of excretion of radioactivity, parenchymal retention may then be differentiated from dilated or obstructed uropathy. 1 Glomerular Filtration Rate (GFR) The patient should neither eat nor smoke during the preceding 4 h. Fluids, with the exception of tea or coffee, are allowed. v. injection of 40 MBq technetium-99m-DTPA, followed by six blood samples taken from the recumbent patient 5, 15, 120, 150, 180 and 210 min after the injection.
The method has a sensitivity of only 50%-70% for anatomical renal artery stenosis. However, when the stenosis exceeds 70%, the sensitivity is 90%, and the predictive value for an antihypertensive effect of successful revascularization is 93% (Fommei et al. 1991). Bilateral changes impose a diagnostic problem, and the specificity of 80%-85% is not too impressive. Specificity can be improved by using technetium-99m-DTPA and performing two sequential renographies, one with and the second without captopril.
We have treated eight patients for stenosis in the remaining in situ kidney. Six patients were successfully treated by one PTRA, and one patient after three PTRAs. In one patient the attempt was unsuccessful. 05 years}. 2 Percutaneous Transluminal Renal Angioplasty of the Autotransplanted Kidney New stenoses may evolve in the iliac artery, in the anastomosis between the renal and the iliac artery, and in the renal artery. PTRA can be performed successfully in most of these stenoses (Fig. 15). 1}.
Extracorporeal Renal Surgery and Autotransplantation by Anders Hartmann, Per Fauchald (auth.), Inge B. Brekke MD, PhD, Audun Flatmark MD, PhD (eds.)