Partial Resection of the Renal Pelvis and Lower Pole of the Kidney for Hydronephrosis

Abstract

IN 1953 one of us described partial resection of the kidney and renal pelvis in the treatment of large hydronephroses (Hjort, 1953). The present paper gives an account of the use of this method of treatment in a general surgical department over a period of 25 years.According to our view reconstructive surgery for hydronephrosis has 2 objectives. The first is removal of the primary cause of obstruction and the second is reconstruction of the physiological funnel-shape of the renal pelvis. Regardless of the type of obstruction in hydronephrosis, the kidney and renal pelvis are fundamentally altered as a result of long-standing back pressure. We suggest that the resulting change of shape has the effect of adding to the obstruction.According to the hypothesis which forms the basis for the present operation the funnelshape of the renal pelvis is essential for its emptying. The aim of the operation is to transform the hydronephrotic kidney and renal pelvis into a funnel at the expense of the lower pole of the kidney. The operation is, in principle, identical with the " resection orthopidique pyilo-renale ",