[Reabsorption of the irrigation solute during percutaneous nephrolithotomy]

The publication of several accidents, possibly due to the reabsorption of irrigation solutions in the course of percutaneous nephrolithotomy, prompted the authors to quantify the amounts of glycine (1.50 per cent glycocol) reabsorbed in these operations, and to determine the metabolic consequences. In a prospective study of twelve patients subjected to fourteen percutaneous nephrolithotomies, the hemodilution parameters (natremia, protidemia, hematocrit and osmolality) and the amino acid content of the plasma were measured preoperatively, at operation, and immediately postoperatively. The study indicates that there is a hemodilution and reabsorption of irrigation solute comparable to that observed in transurethral resections of the prostate. The resultant hyperglycinemia probably explains the significant increase in ammonemia noted in all the patients. One theory is that hepatocellular insufficiency may increase this ammonemia. This might suggest the advisability of using saline solution, at least in these patients (that is, of course, in the absence of electrical lithotrity).