Double kidney stones with hydrops, minimally invasive open surgery

Agree that the clouds will dissipate.

To add. 1. If they are all ureteral stones, they can be solved at one time, and if there are kidney stones, percutaneous nephroscopy is required, which may need to be divided into parts.

2. Physical strength and appetite are not the main factors that determine surgery. It depends on blood pressure, hemoglobin, and kidney disease that can be delayed.

3. The cause of blood pressure drop needs the support of other examinations to be clarified.

1. Don't advocate it, the risk is too great. 2. Bilateral lesions must be separated, in order to avoid sudden acute renal failure after surgery, leave one side to compensate, which is safe. 3. If your blood pressure drops so low, is there no blood routine?

You mentioned that you had hematuria, and if it was all bright red urine for the past two days, it could not rule out ureteral damage and bleeding.

First, it is recommended that you do not rush to have a second operation, as life is more important than stones.

Second, if there are multiple stones or huge antler-shaped stones or cast stones, some of them cannot be taken at one time, and it is normal to do them two or three times.

Thirdly, the blood pressure dropped two days after surgery, and there was hematuria after surgery, which is estimated to be hypotension caused by postoperative bleeding, and has no obvious relationship with anesthesia. If the anemia is not corrected, and you rush to have a second operation, in case of heavy bleeding, it is estimated that both of your kidneys are in danger, and it is recommended that you postpone the operation, and you will need at least a month of rest. If there is anemia, you should have blood transfusion to correct the anemia before the operation, and prepare blood before the operation.

There are incision and minimally invasive surgical methods, so if it is hydronephrosis surgery, is it incision or minimally invasive?

Hydronephrosis surgery is usually performed minimally invasive rather than incisive. The principle of hydronephrosis is to relieve obstruction and remove it as soon as possible, to protect kidney function to the greatest extent, control infection, prevent complications, and switch to surgery when non-surgical ** cannot achieve relief**. If percutaneous nephrostomy surgery is performed, it can be performed under ultrasound guidance, and the damage is relatively small, so that the fluid can be relieved as soon as possible and the compression of the renal parenchyma can be prevented.

For those who need long-term drainage due to severe lesions around the renal ureter, ureters and double tubes should be placed through the cystoscopy to eliminate the effusion. Renal resection may be considered if severe hydronephrosis has led to compressive atrophy of the renal parenchyma, basic loss of renal function, or is accompanied by severe infection and pyometra.

Multiple stones and fluid accumulation in the left kidney can be used for minimally invasive surgery.

You can do percutaneous nephroscopic stone removal crack resistance, if it goes well (a successful operation to remove stones), you can be discharged from the hospital after 6 days after the operation, about 10,000 yuan, you had better bring ** and other examination materials to see. Every Wednesday morning special needs outpatient clinic (the treatment and ** locations are on the 12th floor of the outpatient and emergency building, and you can contact the special needs outpatient department if you need to see a doctor at other times), and every Wednesday afternoon expert outpatient clinic.

Liu Jianhe, Shanghai Xinhua Hospital.

Analysis:

Hello, the ** of kidney stones is determined according to the size of kidney stones, generally if the diameter of kidney stones is less than 1cm, you can not operate, traditional Chinese medicine should drink Defu's Radix tea as soon as possible, so as not to change or aggravate the condition, dissolve stones, drink more water, but if the stones are greater than 1cm, surgical stone removal is required Generally, it is now more widespread, extracorporeal shock wave lithotripsy, if it does not work, percutaneous nephroscopy, or transurethral nephroscopy (lithotripsy).

Guidance: Hello, if it is a small stone with a diameter of less than 2mm, you can consider traditional Chinese medicine to remove the stone, if the stone is large, it is best to use surgery to remove it, or use ultrasonic lithotripsy with a combination of traditional Chinese and Western medicine**. Patients with kidney stones need to adjust their diet appropriately to prevent the recurrence of stones. Patients with calcium-containing stones should eat less calcium-rich diets such as milk, and patients with oxalate stones should eat less spinach, potatoes, beans and strong tea.

Hello, kidney stones** methods can be divided into conservative** and surgical**. The need for surgery** depends on the size of the stone, the location of the stone, and the patient's specific situation.

Conservative of kidney stones**:

Conservative** is suitable for patients with nephrolithiasis with stones less than 1 cm in diameter and no urinary tract obstructive lesions. Drinking plenty of water, expelling stones with traditional Chinese medicine, and exercising moderately are used to help the stones pass away on their own. Patients with colic are treated with analgesics, antispasmodic, etc.

Co-infected patients are also given anti-infection**. Because kidney stones must pass through the ureters to pass on their own, they are more likely to pass on their own than ureteral stones. The reminder is that kidney stones should be treated as soon as possible, and you can drink Depu's Shiqi tea, which can effectively remove stones, and there is no ***.

It should be noted that if the stone cannot be discharged after a period of time, it is necessary to consult the doctor in the hospital and consider other methods to remove the stone.

Surgery for kidney stones**:

For relatively large stones (transverse diameter of 1cm or more), which are conservative** and difficult to discharge, it is necessary to do minimally invasive surgery for treatment, or break the large stones, and then take stone removal drugs to promote stone removal after surgery.

1) Extracorporeal shock wave lithotripsy.

Extracorporeal shock wave lithotripsy is the use of external shock wave focusing to break up the stones in the body so that they can be excreted with urine. The advantage is that there is no need for anesthesia, no hospitalization, and it can be received on an outpatient basis**. The disadvantage is that it is not effective for larger and more complex stones, and the kidneys are damaged after many times.

Note: The total number of extracorporeal shock wave lithotripsy is best mastered less than three times.

2) Percutaneous nephrolithotomy.

Percutaneous nephrolithotomy is a technique and means to remove stones and relieve obstruction with the help of lithotripsy and stone removal instruments under the direct vision of the endoluminal nephroscope. At the same time, this method is a minimally invasive surgical technique, with an incision of less than 2cm, which has the advantages of high success rate of stone removal, less pain, fewer complications and wide indications.

3) Open surgical lithotomy.

Due to the advent of minimally invasive techniques, the traditional open stone removal surgery has almost been eliminated, and compared with minimally invasive techniques, these open surgeries are more traumatic to the body, more painful, more complications, have a greater impact on kidney function, and have a long postoperative recovery time. At present, open surgery is only suitable for a small proportion of patients with comorbidities.

Different types of kidney stones are performed differently in the later stages, which is worth paying attention to for all patients. If you are in the early stage of kidney stone disease, there may not be a need for surgery**, or you may be able to use ordinary conservative**. **The principles are:

Early detection, early detection**.

Hello: According to your above situation, your current stone problem has been solved. Moderate hydrauties in the kidneys are thought to be due to ureteral stones or ureteral strictures.

Fluid accumulation is caused by a blockage in the ureters. Currently, if your stone has been broken, the recovery of hydronephrosis takes time and varies from person to person. Some patients take a month, half a year, or even a year for the water to be fully absorbed.

If you do have a stenosis in your ureter, choose based on the degree of stenosis**. If the stenosis is severe, surgery is needed to improve it. It is recommended that you go to the hospital to have your water accumulation checked regularly.

Wishing you a speedy recovery! lx

All I can say is that after the surgery, the bleeding after surgery can be caused by a variety of reasons. Due to the abundant blood flow in the kidneys and the fragility of the tissues, it is not easy to suture to stop bleeding, and the patients have heavy bleeding within 48 hours after surgery. Due to the imperfection of hemostasis during surgery, attention should be paid to the depth of blood in the drainage fluid, whether the drainage tube is unobstructed, and the degree of hematuria should be observed.

After surgery, you should stay in bed absolutely for 2 weeks, 7 to 10 days is the intestinal absorption period, especially to measure blood pressure and pulse regularly, keep the stool smooth, and enema if necessary. Constipation or coughing can cause bleeding when exerted.

Prevent infection. Prevent urine leakage. The perirenal drain should be left in place for at least 4 days until there is no exudate before it can be removed.

Hello, I don't know if you saw this report from **, according to the recovery of many stone patients, the phenomenon you said will not appear, because the current minimally invasive technology is much superior to the traditional technology, these phenomena will only be reflected in the traditional surgery, but the history of minimally invasive technology will have. The incision of minimally invasive techniques is very small and does not cause such a phenomenon.

If the stone is indeed larger, it is generally a staghorn-shaped stone, full of kidneys, the stone is hard, and it is impossible to have a lithotripsy, then surgery is indeed required, it is not serious enough to such a situation or it is recommended to consider conservative ** with extracorporeal lithotripsy, otherwise even if the stone constitution has not changed after the operation, it will still be **, please consider it clearly.

Traditional Chinese medicine believes that hydronephrosis is mostly due to spleen and kidney deficiency, and water and dampness are not lucky; or because there is no sand and gravel obstruction, it affects the flow of water; Or the damp heat and scorching yin in Pants Mountain State, the gasification is unfavorable, and the waterway is not smooth. In addition, different parts of water accumulation will have different clinical manifestations, but the cause of hydronephrosis is caused by the lack of yang qi and the inability to warm the water liquid, and the water and liquid stop accumulating and cause yang deficiency qi damage, while yang deficiency qi loss cannot warm water drinking. **The main prescriptions used for hydronephrosis are Banxia, Lulutong, Licorice, Hyssop, Talc, Rhubarb, Psyllium, Peilan, Motherwort, Huoxiang, and Salvia.

Patients with renal insufficiency who are accompanied by stones can be treated with chicken gold, desmodium, and sea sands; If the tongue is dark and there is ecchymosis, 20 ml of Mai Luoning injection or compound Danshen injection should be given, added to 250 ml of 5% glucose solution, and intravenous infusion once a day; It is not good to urinate and add cork and wood; For patients with hematuria, white grass root, arborvitae leaves, puhuang, etc. should be added.

The first level of gallbladder stones depends on the specific situation of the stones, such as the size of the stones, how many, the function of the gallbladder and the symptoms of the patient, etc., if the stones are not very serious, you can take medicine to remove stones, and traditional Chinese medicine has the effect of dissolving fossils and stones. If the stone is severe, surgery is required**.

Stones directly affect the normal life of many people, and you must treat them quickly, not only for yourself, but also for the physical and mental health of your family.

Dzy is afraid of harming the plate.