The tumor was limited to the kidney parenchyma, without the involvement of the
renal capsule or the perihilar fat (stage pT1bNx).
Malignant fibrous histiocytoma arising from the
renal capsule: Report of case.
Invasion of the
renal capsule and adipose tissue was seen with negative surgical border.
The needle is observed for swinging as the patient breathes, to confirm needle placement at the
renal capsule (Terrill, 2002, Richard, 2001) as the kidney is anchored to surrounding structures and abdominal wall, and therefore moves with the diaphram (Tortora & Grabowski, 2003).
The severity of the pain depends on the amount of dilation of the
renal capsule or stretching of the collecting system.
Subcapsular urinomas occur between the renal parenchyma and the
renal capsule whereas perirenal urinomas are between the
renal capsule and the Gerota's fascia.
(16,17) Briefly, after Gerota's fascia is opened, the
renal capsule is visualized around the tumour.
The tumor has been hypothesized to originate from mucosa-associated renal lymphoid tissue or from lymphatics in the
renal capsule [3, 4].
The lymphatics of
renal capsule and renal parenchyma drains into the renal sinus lymphatics.
The following groups were evaluated: Sham, only removal of the
renal capsule; NPX, 5/6 NPX and simultaneous complete omentectomy to prevent omentum from fusing to the injured kidney; NPX + OM (omentum), 5/6 NPX and pedicled greater omental direct packing on the remnant renal tissue; NPX + OM + ESCs, 5/6 NPX and pedicled greater omental packing of free ESCs on remnant renal tissue; and NPX + OM + GMs + ESCs, 5/6 NPX and pedicled greater omentum packing of ESC-loaded GMs on remnant renal tissue.
(Selective angio embolization in 3 cases) Table 5: Complications among 500 s-PCNL procedures Number Rate % Intraoperative Minor renal parenchymal Injury 30 6%
Renal Capsule Rupture 7 1.4% Significant bleeding 15 3% Renal collecting system Injury 15 3% Early Post-operative Fever / Urosepsis 17 3.4% Persistent Haematuria 7 1.4% Flank Pain 18 3.6% Pleural Effusion 3 0.6% Hemothorax 1 0.2% Study Number of Multiple Stone free Patients Access rate Present Study 500 176 (35.2) 472 (94.4) P.N.
