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Principal technical features are described briefly based on a personal series of use of the procedure in 35 cases. The patient is placed in decubitus; a parietal approach is performed while avoiding the genitofemoral nerve; the incision can be enlarged downwards and above all upwards (subperiosteal segmental resection of 12th rib). The lateral posterior vertical lumbotomy possesses the advantage over classical lateral lumbotomy of being less disturbing to muscle, being less painful postoperatively, and never leading to eventration. It also reduces hospital stay. It presents the disadvantage, however, of providing only a narrow view of the operation zone, which limits its use to simple procedures such as exeresis of pyelic and upper lumbar ureteral calculi. It is dangerous, on the contrary, and should not be used in surgery of coralliform stones.

Results of 334 appendectomies carried out through the umbilical orifice are reviewed. Failures of treatment and complications of the method are reported while emphasizing that only 4 major complications occurred. When compared with the classical incision of right iliac fossa this procedure does not appear to provoke more risks and presents obvious esthetic advantages.

On the basis of a case of partial nephrectomy of a single functioning kidney performed with immediate success in a 77-year-old woman, the author reviews the main data from the literature concerning this particular treatment of carcinoma of the kidney. In the great majority of cases the carcinoma required partial nephrectomy only because the affected kidney was single. Operative mortality was low : 2.6 %. Three year survival is 61 % of cases and it is important to note that terminal renal failure and recurrences in the remaining portion of the kidney are rare. Metastases represent the chief cause of death. Survivals ranging from 6 to 14 years have been reported. When the fact that the kidney is single is not because of nephrectomy for a carcinoma, the prognosis after partial nephrectomy is the same as that after wide excision for carcinoma (in patients with both kidneys). When the opposite kidney had been the site of a carcinoma and even more so in the presence of metastases, the prognosis becomes far less good. With a single kidney, the development of a carcinoma does not necessarily imply the need for total excision of the kidney followed by intermittent haemodialysis. A partial nephrectomy is worth the attempt when it appears to be reasonable. A number of particular technical features are emphasised : - the need for prior arteriography which defines the respective topography of the tumour and the renal vessels, - the safety of temporary clamping of the renal artery when the kidney is made hypothermic by cooling using ice piled up in contact with the kidney, - the possibility of performing such an excision in situ via an appropriate surgical approach.

The authors report 2 cases of a condition often overlooked by the urologist: incrusted cystitis. It shows up clinically with severe urinary troubles and bladder calcifications. In fact the main finding is calcified plaques in the mucosa causing an inflammatory reaction and mimicking a tumor. Histologic examination of endoscopic biopsies rules out tumor and reveals a calcified necrotic mucosa. A high degree of alkalinity of the urine makes the diagnosis of incrusted cystitis after ruling out tuberculosis and bilharziasis. Acidifying the urine clears up the trouble and brings the bladder mucosa back to normal. According to the literature, 3 factors are necessary for the development of incrusted cystitis: a ureolytic microbe capable of releasing ammonia, alkalinity of the urine resulting from this, and a bladder with lesions of cystitis whatever might be the cause. A number of diagnostic errors are possible, but the most serious one is mistaking it for a calcified malignant tumor of the bladder. For this a biopsy is essential to prove the absence of a tumor. The treatment consists of 3 stages: excision of the calcified plaques (mostly by endoscopy), sterilization of the urine (nalidixic acid would be the best agent) and acidification of the urine.