What Is a Nephrotomy?

Urinary stones are one of the most common diseases of the urinary system. The incidence of upper urinary stones is higher than that of lower urinary stones. Kidney stones account for more than half of the upper urinary stones. Stones can cause hydronephrosis and renal dysfunction caused by urinary tract obstruction. If concurrent infections can accelerate kidney damage, bilateral lesions can lead to uremia and even death if not treated effectively. At present, the treatment of stones is mostly through minimally invasive or non-invasive surgical methods, and open surgery has been rarely used.

Basic Information

Chinese name

Nephrotomy

Visiting department

Urology

Kidney incision and anesthesia and preoperative preparation

Anesthesia mode

Epidural or general anesthesia.

2. Preoperative preparation

(1) If there is an acute urinary tract infection, surgery should be performed after it is cured. There were no cases of infection. Antibiotics were applied 48 hours before surgery to prevent postoperative infection.

(2) Prepare blood for 300 600ml.

Indications for nephrolithotomy

1. Kidney stones, stones larger than the kidney neck can not be taken through the pelvic incision.

2. Antler-shaped stones incarcerated in the renal pelvis and calyces, who cannot take the stone through the renal pelvis in the renal sinus.

3. The stones are small and the position in the kidney is not sure.

Nephrectomy stone removal procedure

The general steps of surgery: incision and exposed kidney. Block kidney blood flow. Simple kidney parenchyma is taken for stone. The renal pelvis and renal parenchyma were cut open to take stones. Hemostasis. Suture the kidney incision. If there is more blood in the kidney, a pyelostomy or nephrostomy should be performed. The incision was closed with quilting and drainage was placed.

Postoperative complications of nephrotomy

Urinary leakage and frequent urination in the incision, postoperative bleeding, residual stones, and persistent urinary tract infection.

Nursing after nephrectomy

Routine nursing after anesthesia, wound cleaning, unobstructed drainage tube fixation, pain care, health education, and proper indoor activities 3 days after surgery

Precautions for nephrotomy

1. Absolutely stay in bed for 1-2 weeks.

2. Closely observe the postoperative hematuria and intrarenal hemorrhage.

3. Continue to apply antibacterial drugs to prevent infection.

4. The rubber drainage tube was removed 72 hours after surgery.

5. If there is a pyelostomy, remove it after surgery.

Diet after nephrectomy

Light and digestible diet, drink plenty of water, adjust the type of diet according to the composition of the stones.