The Value of Coagulum Pyelolithotomy

The unit volume (4 to 18 ml.) of cryoprecipitate provided by the blood bank is sometimes inadequate to fill a given pelviocaliceal system. The effect of diluting the cryoprecipitate with urine, saline and water to increase this volume was investigated. Samples of cryoprecipitate were expanded with urine, saline solution and water in proportions of 3:1 and 1:1 at 37C. One part of 10 per cent calcium chloride was added to the various dilutions for each 20 parts of unexpanded cryoprecipitate. All samples resulted in tenacious coagula. The mean generation time of the coagula was 2.25 minutes with water expansion, and 3 to 4.5 minutes when diluted with urine and saline. The mean tensile strength decreased 44 to 64 per cent with water expansion, and 7 to 32 per cent when diluted with urine and saline. Water expansion is not recommended because of the marked decrease in generation time and tensile strength. In patients cryoprecipitate expanded with urine or saline provided tenacious coagula.

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Coagulum Pyelolithotomy: Impact on Unrecognized Stones

Kalash

Young

1985

Journal of Urology

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The use of coagulum free of thrombin to remove 313 renal calculi from 46 patients is reviewed. Twenty-six additional calculi removed from 17 patients were not apparent on preoperative studies. Of the 313 stones apparent preoperatively 3 were not extracted in the coagulum. Other means (stone forceps and so forth) were used to deliver 2 of these calculi and 1 was left in the kidney. Incisions used for these procedures included the conventional flank incision in 9 patients, a 10 cm. posterior flank incision in 30 and lumbotomy in 7. Adjunctive use of coagulum in 8 additional patients is presented. The recovery of more than the preoperatively identified renal calculi may be an advantage for coagulum pyelolithotomy. The length of hospital stay in these 46 patients averaged 4.8 days, with an average operative time of 1.22 hours. The patients returned to work within an average of 13 days. We suggest that these data are comparable to other methods of pyelonephrolithotomy.

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The Value of Coagulum Pyelolithotomy

Cited by 3 publications

References 9 publications

Modern Strategies in Stone Surgery, with Special Emphasis on Prevention of Stone Recurrence

Modern Strategies in Stone Surgery, with Special Emphasis on Prevention of Stone Recurrence

Expansion of Inadequate Volume of Coagulum For Pyelolithotomy: An Experimental and Clinical Study

Coagulum Pyelolithotomy: Impact on Unrecognized Stones

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