腎切開術에 있어서 接合方法에 關한 硏究 = Experimental and Clinical Study on the Closure Technique in Nephrotomy

다국어 초록 (Multilingual Abstract)

It has been believed that the use of sutures in closing nephrotomy wound may increase the likelihood of extersive infarction, causes tissue strangulation, distortion, obliterates tubules, makes the chance of secordary hemorrhage more likely and reduces renal function.
Paramo and his co-workers have found that the incidence of postoperative hemorrhage is reduced when sutuies are not used. Recently a technique to colse wounds by meats of tissue adhesives has beenattempted in many branches of surgery. Negative and positive results of its use in renal surgery have been reported.
In this paper, comparative studies performed among these three methods are introduced to evaluate their superiority.
12 adult mongrel dogs are devided into 3 groups and experimental nephrotomy was first performed oneach of these dogs. Mattress sutures with 4-0 chromic catgut to close nephrotomy wounds were applied in the first group (4 dogs), while tissue adhesive (alkyl-α-cyanoacrylate) was used in the 2nd group. The third group received closure of renal capsule only, no catgut sutures or adhesive were used for the closure of nephrotomy wound. Nephrectomy of these kidneys was done serially with an interval of 6 weeks, 7 weeks, 8 weeks and 9 weeks after preceeding nephrotomy.
A clincial observation was done on Selected 4 cases of kidney stone including a case of staghorn calculus where a bivalve nephrolithotomy was performed. For closing the nephrotomy wound, mattress sutures of 4-0 chromic catgut were applied in 3 cases and no mattress sutures or adhesive materials were used in one case.
The results obtained were as follows
Ⅰ. Animal experiments:
1) Group 2 revealed dense and wide fibrous tissue with marked cell infiltration. Granulomatous lesions were seen in all specimens.
2) Group 3 revealed the least tissue reaction and linear scar formation.
3) Group 1 revealed a similar degree of tissue reaction to the group 3, but slightly wider scar tissue than that of the group 3.
Ⅱ. Clinical observation:
All 4 patients including one case in which no mattress sutures or adehesive materials were used, cured well without any specific complications.

목차 (Table of Contents)

• Ⅰ. 緖論
• Ⅱ. 動物實驗
• 1) 材料 및 方法
• 2) 成績
• Ⅲ. 臨床硏究
• Ⅳ. 總括 및 考按
• Ⅴ. 結論
• 參考文獻