From Big Medical Encyclopedia

DECAPSULATION OF THE KIDNEY (decapsulatio renis; lat. the de-prefix extraction, destruction + capsula the capsule, a bag) — removal of a fibrous renal capsule. It was for the first time executed by Edebols (G. M of Edebohls) in 1901 at the patient with the renal failure caused by disturbance of blood supply of a kidney.

the Scheme of a section of a fibrous renal capsule on a fluted probe.

Was considered that removal of the fibrous capsule eliminates a prelum of a parenchyma of a kidney with a low-elastic case and owing to free outflow of the accumulated interintercellular lymph in pararenal space reduces intersticial hypostasis, reduces intra renal pressure. However bigger value has that after removal of the fibrous capsule the small vessels from a surrounding fatty tissue which are a little improving blood supply of body grow into a renal parenchyma. On the basis of it it is offered to shroud the decapsulated kidney in the epiploon removed on a leg through an opening in a peritoneum (Omentorenopexy) or a segment of a jejunum.

Dative leads to emptying of subcapsular abscesses that increases efficiency of treatment of acute purulent diseases of kidneys.

Dative in complex treatment of acute nekronefroz, pyelonephritis and a glomerulonephritis is not applied. The main indications to Dative are apostematous nephrite (see), anthrax of a kidney (see), perinephritis. Decapsulation of the transplanted kidney is sometimes made.

Technology of operation

is allocated with the Lumbar section a kidney, edges then removed in a wound. On the outer edge of a kidney in the fibrous capsule do a section, under the fibrous capsule enter a fluted probe, with the help to-rogo it cut from upper to the lower pole (fig). The Otsloyenny capsule can be left or excised in the field of «renal gate». At a combination of Dative with nephrostomy (see) it is necessary to leave the site of the fibrous capsule on the lower pole for the prevention of pro-cutting of the seams fixing a drainage tube to a renal parenchyma. Dative — auxiliary operation, a component of complex therapy, and its results are defined by a current of a basic disease.

Bibliography: Pytel A. Ya. Enterorevaskulyarization of a kidney in treatment of a nephrogenic hypertension, Urology, No. 5, page 3, 1963; it, Clinical value of piyelorenalny refluxes, Barnaul, 1975; Rozov N. I. About influence of decapsulation on function and a structure of a kidney, a yew., Kiev, 1911; Fedorova M. N. Creation of additional vascularization of kidneys at the expense of muscular tissue, an epiploon and a hypodermic fatty tissue, Urology, No. 2, page 3, 1961; Babies A. u. E e n at i - V a m about s F. Das Lymphgefasssystem der Niere und seine Bedeutung in der Nieren-pathologie und Chirurgie, S. 472, Budapest, 1957, Bibliogr.; Mayor G. u. Zingg E. J. Urologische Operationen, S. 34, Stuttgart, 1973.

E. G. Aslamazov.