Low-invasive techniques in the treatment of urolithiasis with application of innovative equipment made in Russia


Cite item

Full Text

Abstract

A total of 1100 sessions of extracorporeal shock wave lithotripsy (ESWL) were made in 720 patients with urolithiasis in the last decade with application of LGK-Compact lithotripter which generates shock waves electrodynamically and has no focusing lens. Such lithotriptor allows ESWL in patients with a high anesthesiological risk. Fitting the LGK-Compact lithotriptor with an endourological complex ENDO-MIT tooled for low-invasive interventions under X-ray control enabled treatment of 467 patients with urolithiasis aged 30-80 years. Most of the patients (66.04%) were at the productive age of 18-50 years. ESWL on the LGK-Compact lithotriptor was made in 182 patients (mean number of sessions was 2.1). Six and 12 month follow-up examinations registered complete elimination of the fragments in 169 patients. Thirty-four patients with concrements of the intramural ureter were exposed to 1 to 3 sessions. The fragments eliminated for 1-14 days after the session in 25 patients. Three patients developed stone path which evacuated spontaneously in two cases. For 3 years transcutaneous nephrolithotripsy was conducted in 214 patients. The concrements were removed during one operation in 156 (72.9%) patients, 58 (26.1%) patients had residual fragments. Reoperation was made in 34 patients 7-12 days after the first intervention. In the rest 24 cases (11.2%) residual fragments were removed by means of ESWL on LGK-Compact. Thus, ESWL is a leading technique in management of uncomplicated uroliths maximum 2 cm in size. When indications to ESWL are limited or this method is not effective, the role of roentgenoendoscopic interventions, such as transcutaneous nephrolithotripsy and transurethral contact ureterolithotripsy, takes on special significance. Such clinical innovation as endourological complex ENDO-MIT with lithotripter LGK-Compact made in Russia opens new perspectives of the treatment of urolithiasis and other urological diseases due to introduction of novel highly effective domestic technologies leading to a significant reduction in the number of postoperative complications and time of treatment, to 1.5-2 fold reduction in costs of equipment compared to foreign analogues.

References

  1. Лопаткин Н. А., Яненко Э. К. Мочекаменная болезнь. Рус. мед. журн. 2000; 3: 117-120.
  2. Лопаткин Н. А., Трапезникова М. Ф., Дутов В. В., Дзеранов Н. К. Дистанционная ударно-волновая литотрипсия: прошлое, настоящее, будущее. Урология 2007; 6: 3-13.
  3. Трапезникова М. Ф., Дутов В. В., Уренков С. Б. и др. Бесконтактное разрушение мочевых камней. Рос. мед. журн. 1996; 1: 49-53.
  4. Morris D. S., Taub D. A., Wei J. T. et al. Regionalization of percutaneous nephrolithotomy: evidence for the increasing burden of care on tertiary centers. J. Urol. (Baltimore) 2006; 176 (1): 242-246.
  5. Дзеранов Н. К., Яненко Э. К. Оперативное лечение коралловидного нефролитиаза. Урология 2004; 1: 34-38.
  6. Дзеранов Н. К., Бешлиев Д. А. Лечение мочекаменной болезни - комплексная медицинская проблема. Consilium Medicum 2002; Прил.: Урология: 18-22.
  7. Дзеранов Н. К., Лопаткин Н. А. Мочекаменная болезнь. Клинические рекомендации. М.: Оверлей; 2007.
  8. Дутов В. В. Современные аспекты лечения некоторых форм мочекаменной болезни: Автореф. дис. ? д-ра мед. наук. М.; 2000.
  9. Джабер Д. Перкутанная хирургия нефролитиаза: Автореф. дис. ... канд. мед. наук. М.; 2002.
  10. Алиев М. Г. Дистанционная литотрипсия в комплексном лечении резидуальных камней почек: Автореф. дис. канд. мед. наук. М.; 2001.
  11. Chaussy C. G. Extracorporeal shock wave lithotripsy. 2-nd ed. Basel: Karger; 1986.
  12. Бешлиев Д. А. Опасности, ошибки, осложнения дистанционной литотрипсии, их лечение и профилактика: Автореф. дис. ...д-ра мед. наук. М.; 2003.
  13. Трапезникова М. Ф., Дутов В. В. Применение ДУВЛ-монотерапия при коралловидном нефролитиазе. Урология 2004; 1: 38-43.
  14. Лопаткин Н. А., Дзеранов Н. К. Пятнадцатилетний опыт применения ДЛТ в лечении МКБ. Эффект. фармакотер. в урол. 2007: 2: 20-25.
  15. Дзеранов Н. К., Москаленко С. А. Новый подход к повышению эффективности и объективизации дистанционной литотрипсии. Урология 2006; 6: 6-8.
  16. Зиборова И. В., Лопаткин Н. А., Сивков А. В. Социально-экономические аспекты Федеральной целевой программы "Урология". Экономика здравоохр. 1999; 4: 12-15.
  17. Лопаткин Н. А., Мартов А. Г., Камалов А. А., Пущин Б. Л. Пневматическая контактная литотрипсия. Урол. и нефрол. 1994; 6: 2-5.
  18. Тиктинский О. Л., Александров В. П. Мочекаменная болезнь. СПб.: Питер; 2000.
  19. Трапезникова М. Ф., Дутов В. В. Дистанционная ударно-волновая литотрипсия в лечении уролитиаза дистопированных почек. Урология 2006; 2: 3-6.
  20. Arrabal-Martin M., Fernгndez-Rodriguez A., Arrabal-Polo M. A. et al. Extracorporeal renal lithotripsy: evolution of residual lithiasis treated with thiazides. Urology 2006; 68 (5): 956-959.
  21. Vupputuri S., Soucie J. M., McClellan W., Sandler D. P. History of kidney stones as a possible risk factor for chronic kidney disease. Ann. Epidemiol. 2004; 14 (3): 222-228.
  22. Yilmaz E., Batislam E., Basar M. et al. Optimal frequency in extracorporeal shock wave lithotripsy: prospective randomized study. Urology 2005; 66 (6): 1160-1164.
  23. Abe T., Akakura K., Kawaguchi M. et al. Outcomes of shockwave lithotripsy for upper urinary-tract stones: a large-scale study at a single institution. J. Endourol. 2005; 19 (7): 768-773.
  24. Eigenerger F. et al., eds. Stone therapy in urology. Stuttgart; New York: Verlag; 1991.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2009 Bionika Media

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies