This journal is
indexed in Scopus
Year 2012 Vol. 20 No 4
A.G. BEREZHNOY, E.V. DYABKIN, F.P. KAPSARGIN, A.A. ZALEVSKIY
TOPOGRAPHIC AND ANATOMIC BASIS OF A SURGICAL ACCESS TO KIDNEY
State Budgetary Educational Establishment of Higher Professional Education “Krasnoyarsk State Medical University named after Professor V.F.Voyno-Yasenetsky”
The Russian Federation
Objectives. To identify topographic and anatomical peculiarities of the XII rib structure in order to develop a new operational access to the kidney.
Methods. The investigation was carried out on 30 corpses referred to the second period of the adulthood. It included 18 males and 12 females. Refinement of the technique and studying the parameters of operational access to the kidney with a longitudinal incision of the XII rib was performed by the method of A.Yu. Sozon-Yarashevich supplemented by A.G. Mirzamuhamedov. To assess the approach one used the following parameters: the depth and width of the wound, the inclination angle of the operation action axis, the operating inclination angle along the wound length, the operating angle of the wound width.
Results. The average depth of the wound made up 6,49±0,11 cm. The minimum depth of the wound was 4,5 cm, and the highest – 7,8 cm The average width of the wounds was equal to 7,44±0,12 cm: the lowest – to 6,0 cm, and the highest – 9,0 cm. The average value of the inclination angle of the operation action axis made up 87°±0,4. In our studies the angles of the operational actions from 86,8° to 90° occurred in 77% and from 80° to 86,8° - in 23% of cases. The average value of the operating angle of the wound length was 95°±1,0 and these values were recorded in half of cases. The average angle of operation according to the width of the wounds was equal to 61°±1,2. The research results showed that the spatial relationships in the wound are characterized above all by the angle of the operating action determined both according to the length and the width of the wound.
Conclusions. The investigation of the parameters of the operational access to the kidney with a longitudinal incision of the XII rib confirms its topographic and anatomical appropriateness. This operational access should be used in patients with complicated forms of urolithiasis requiring the open surgery.
1. Ibatullin IA. Klinicheskaia anatomiia i poliklinicheskaia khirurgiia [Clinical anatomy and polyclinic surgery] Kazansk Med Zhurn. 2006;(5):395–97.
2. Kernesiuk NL. Operativnaia khirurgiia i topograficheskaia anatomiia kak nauka i fundamental'no-prikladnaia distsiplina [Operative surgery and topographical anatomy as a science and fundamental applied discipline]. Vopr Rekonstrukti i Plastich khirurgii.2007;(4):160–61.
3. Fomin NF. Atlas Topograficheskaia anatomiia raspilov cherez zamorozhennoe telo cheloveka – vershina nauchnykh dostizhenie NI Pirogova
[Atlas Topographic anatomy of cuts through the frozen body of a man - the top of the scientific achievement of NI Pirogov]. Vopr Rekonstruk i Plastich Khirurgii. 2009;(2):38–43.
4. Bol'shakov O. P. Mesto i rol' topograficheskoi i klinicheskoi anatomii v sovremennoi sisteme vysshego obrazovaniia [The place and role of topographic and clinical anatomy in the modern system of higher education]. Morfologiia. 2008(1):7–19.
5. Pytel' IuA, Rapoport LM, Rudenko VI. Medikamentoznaia poliuriia pri operativnom lechenii bol'nykh nefrolitiazom [Drug induced polyuria in surgical treatment of patients with nephrolithiasis]. Urologiia i Nefrologiia. 1998;(5):6–9.
6. Dgebuadze MA, Kordzana DD. Morfofunktsional'nyi analiz lokal'nykh osobennostei sosudistogo rusla pochki [Morphological and functional analysis of the local features of renal vascular bed]. Morfologiia. 2008;(2):39.
7. Agrawal MS, Singh SK, Singh H. Management of multiple/staghorn kidney stones: Open surgery versus PCNL (with or without ESWL). Indian J Urol. 2009;25(2):284–85.
8. Parmar MS. Kidney stones. BMJ. 2004 Jun 12;328(7453):1420–24.
9. Lopatkin NA, Ianenko EK. Korallovidnyi nefrolitiaz [Staghorn nephrolithiasis]. Urologiia i Nefrologiia. 1994;(1):12–16.
10. Bichler KH, Lahme S, Strohmaier WL. Indications for open stone removal of urinary calculi. Urol Int. 1997;59(2):102–104.
11. Toussaint ND. Agar JW, D'Intini V. Calculating glomerular filtration rate in a young man with a large muscle mass. Med J Aust. 2006;185(4):221–22.
12. Sozon-Iaroshevich AIu. Anatomo-klinicheskie obosnovaniia khirurgicheskikh dostupov k vnutrennim organam [Anatomic and clinical foundation of surgical approaches to the internal organs]. Moscow, SSSR: 1954. 180 p.
13. Mirzamukhamedov AG. Vybor shchadiashchikh operativnykh dostupov k pochke i verkhnemu otdelu mochetochnika [The choice of sparing surgical approaches to the kidney and upper ureter]. Tashkent, UzSSR: Meditsina; 1974. 186 p.
660022, Rossiyskaya Federatsiya, Krasnoyarsk, ul. Partizana Zheleznyaka, d. 1, GBOU VPO «Krasnoyarskiy gosudarstvennyiy meditsinskiy universitet imeni prof. V.F. Voyno-Yasenetskogo»,
Dyabkin Evgeniy Vladimirovich
Berezhnoy A.G., Candidate of Medical Sciences, Assistant of Urology, Andrology and Sexology, the Chair of State Budgetary Educational Establishment of Higher Professional Education “Krasnoyarsk State Medical University named after professor V.F.Voyno-Yasenetsky”.
Dyabkin E.V., Candidate of Medical Sciences, Assistant of the General Surgery Chair of State Budgetary Educational Establishment of Higher Professional Education “Krasnoyarsk State Medical University named after professor V.F.Voyno-Yasenetsky”.
Kapsargin F.P., Doctor of Medical Sciences, Head of Urology, Andrology and Sexology Chair of State Budgetary Educational Establishment of Higher Professional Education “Krasnoyarsk State Medical University named after professor V.F.Voyno-Yasenetsky”
Zalevsky A.A., Doctor of Medical Sciences, Professor of the Operative Surgeryand Topographic Anatomy of STATE Budgetary Educational Establishment of Higher Professional Education “Krasnoyarsk State Medical University named after professor V.F.Voyno-Yasenetsky”.