XXXX achieved by retrograde intracavitary saline perfusion.

@entity1707 @entity8 @entity32 @entity12526 @entity548 @entity63 @entity450 @entity432 @entity393 @entity2332
BACKGROUND AND PURPOSE: @entity2332 during vascular clamping protects the kidney from @entity63 -induced @entity393 . Traditionally, cooling is achieved by packing the kidney in ice, which lowers the temperature of the rest of the surgical field as well, and the method cannot be used during laparoscopy. We evaluated the utility of a newly developed ureteral access system for circulating ice-cold saline. MATERIALS AND METHODS: @entity12526 underwent retrograde endoscopic cooling through an access sheath without (N = 2) or with (N = 3) @entity432 , traditional ice-slush cooling with @entity432 (N = 3), or occlusion without @entity2332 (N = 3). Five days later, the @entity1707 were sacrificed and the kidneys and ureters examined histologically. RESULTS: Endoscopic cooling with @entity432 and ice-slush cooling both produced @entity8 . The former produced medullary and cortical temperatures of 21.3 degrees C and 27.3 degrees C, respectively, and the latter medullary and cortical temperatures of 28.8 degrees C and 23.7 degrees C, respectively. Histologically, there were minimal changes in the first three groups, whereas @entity450 , multifocal @entity32 , and periarteriolar @entity548 were seen after @entity432 without @entity2332 . CONCLUSION: Retrograde endoscopic @entity8 is effective and requires no novel equipment or special surgical skills. Clinical application has not yet been attempted.
