[Clinico-morphological value of modified nephropexy method]
S S Dzhaparidze1, S A Dzhaparidze
1Department of Urology, Tbilisi State Medical University, Georgia.
Abstract:
We have observed 28 patients operated by modified method of nephropexy. Principle of this method is the fixation of kidney on 11 or 12 rib with silk floss #5 or #6. Floss is passed subcapsularly around lower pole of the kidney and separately on anterior and posterior surfaces. Duration of the operational intervention was 40-50 min. On the second day after the operation patients were permitted to walk. On the long-term follow-up on 5 months to 6 years, we have studied 24 patients. All of them felt themselves healthy. Second look excretory urography showed no recurrence of nephroptosis. Animal experiment was performed in 5 rabbits and 5 rats. The same operation was carried out on these animals. After 2-6 months kidney and surrounding tissue near used silk floss was studied. Fibrous capsule at the places of floss passing was thickened. Parenchyma of kidney was without changes. There was weak inflammatory reaction in the tissue around the kidney near the floss, which was disappeared at the end of the observation. We propose to introduce this modified method of nephropexy in routine practice of urological surgery.
Insights
This study presents a modified nephropexy technique using silk floss to fix the kidney to the 11th or 12th rib. Long-term follow-up in patients and animal models shows promising results for treating nephroptosis.
Area of Science:
- Urology
- Surgical Innovation
- Nephrology
Context:
- Nephroptosis, or kidneyptosis, is a condition where the kidney drops from its normal position.
- Traditional surgical methods for nephropexy can be invasive and carry risks.
- A modified nephropexy technique offers a potentially less invasive approach.
Purpose:
- To evaluate the efficacy and safety of a modified nephropexy technique for treating nephroptosis.
- To assess the long-term outcomes and recurrence rates of the modified procedure.
- To investigate the histological effects of the silk floss fixation on renal tissues in an animal model.
Summary:
- A modified nephropexy involving kidney fixation to the 11th or 12th rib using silk floss was performed on 28 patients.
- The procedure duration was 40-50 minutes, with patients ambulating on postoperative day two.
- Follow-up of 24 patients over 5 months to 6 years revealed no recurrence of nephroptosis, with all patients reporting good health.
- Animal studies on rabbits and rats showed thickened fibrous capsules and minimal inflammation around the silk floss, with normal kidney parenchyma.
Impact:
- This modified nephropexy technique demonstrates potential for successful, long-term management of nephroptosis.
- The procedure appears safe and well-tolerated, with minimal adverse effects observed.
- Findings suggest this modified nephropexy could be integrated into standard urological surgical practice.
