The Use of Topical Vasodilators as an Adjunct in Infant Renal Surgery

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Abstract
In infant renal surgery there is a well recognized problem with vasospasm and resultant rena ischemia. Vasodilators were applied to the perivascular tissues during renal surgery to prevent vasospasm. With this mode of treatment no renal units were lost owing to ischemia secondary to the operative procedure. The treatment was especially useful in infants with duplicated systems undergoing partial nephroureterectomy. Owing to the diminutive size of infant renal vessels, vasospasm can be triggered easily even with the most careful hilar dissection. To assure maximal preservation of tissue, vasospasm must be prevented before renal mobilization and hilar dissection. To prevent the development of renal ischemia in infants undergoing renal surgery initial exposure of the hilar vessels before dissection, application of papaverine and lidocaine to the perivascular tissues, and delaying further dissection until maximal vasodilation has occurred are recommended.