Креативная хирургия и онкология (Mar 2019)

Correction of Kidney Blood Circulation in Patients with Purulent Pyelonephritis

  • V. A. Ananev,
  • V. G. Lubyansky,
  • A. V. Antonov

DOI
https://doi.org/10.24060/2076-3093-2018-8-4-285-291
Journal volume & issue
Vol. 8, no. 4
pp. 285 – 291

Abstract

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Aim. This paper aims to examine the state of the renal blood circulation in patients with purulent pyelonephritis and to improve the quality of treatment through the use of our own technique.Materials and methods. The author personally examined and operated on 30 patients with confirmed purulent pyelonephritis in the conditions of a urology department at the regional clinical hospital. The author used his own method of treatment. A retroperitoneoscopic decapsulation of the affected kidney was performed on all the patients within the first 24 hours; this was combined with continuous regional arterial infusion of alprostadil within the next 72 hours. All the patients prior to surgery had undergone the following diagnostic procedures: general clinical examination, bolus contrast-enhanced MSCT of kidneys, renal duplex ultrasound, morphology examination.Results and discussion. The postoperative period in all the cases was good with the reduced number of days needed for treatment. On the first day after operation, the patients noted a reduction in the pain intensity in the affected side. The bolus contrast-enhanced MSCT imaging of kidneys in comparison to the data obtained prior to treatment demonstrates the disappearance of the destruction foci in the kidney and a clearly visible restored blood circulation in the affected side achieved rather fast. No patient required a nephrectomy.Conclusion. Every stage of the proposed treatment technique is an inalienable part of the method as a whole. Every stage is necessary to deliver the impact on its level of circulation, on the parenchyma affected by microabscesses, and on the infected areas. The method makes it possible to restore blood flow in the kidney and open up a path for the delivery of antibiotics into the organ parenchyma.

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