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The value of coagulum pyelolithotomy

H Klosterhalfen, L V Wagenknecht, R Busch

    European Urology
    |January 1, 1981
    PubMed
    Summary

    Coagulum pyelolithotomy, a novel surgical technique, effectively removes kidney stones while minimizing residual fragments and the risk of new stone formation. This method utilizes a fibrin coagulum to capture stones, proving safe and efficient in clinical practice.

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    Area of Science:

    • Urology
    • Surgical Innovation
    • Biomaterials in Medicine

    Background:

    • Coagulum pyelolithotomy offers a tissue-conserving approach to kidney stone removal.
    • Minimizing residual stone fragments is crucial to prevent recurrent stone formation.
    • Traditional pyelolithotomy may leave small crystallizations, necessitating improved techniques.

    Purpose of the Study:

    • To evaluate the efficacy and safety of coagulum pyelolithotomy for kidney stone extraction.
    • To assess the rate of residual stone fragments using this method.
    • To determine the risk of hepatitis associated with the procedure.

    Main Methods:

    • A fibrin coagulum was prepared using thrombocyte-enriched plasma, human fibrinogen, thrombin, and calcium chloride.
    • The coagulum was employed in 120 patients undergoing pyelolithotomy for intrarenal stones over seven years.
    • Patient outcomes, including residual fragments and hepatitis incidence, were monitored.

    Main Results:

    • Coagulum pyelolithotomy was performed on 120 patients (84 multiple stones, 36 single stones).
    • Residual caliceal fragments were observed in only six cases (5%).
    • The incidence of hepatitis was negligible, with no significant difference compared to procedures without coagulum, especially when using HBsAG-negative plasma.

    Conclusions:

    • Coagulum pyelolithotomy is an effective and safe method for kidney stone removal, significantly reducing residual fragments.
    • The technique minimizes the risk of new stone formation by ensuring complete extraction.
    • The use of HBsAG-negative plasma renders the procedure safe regarding hepatitis transmission.

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