Laparoscopic pyelolithotomy and its role in modern surgery of nephrolithiasis


Дәйексөз келтіру

Толық мәтін

Ашық рұқсат Ашық рұқсат
Рұқсат жабық Рұқсат берілді
Рұқсат жабық Рұқсат ақылы немесе тек жазылушылар үшін

Аннотация

Aim. To determine the place of laparoscopic pyelolithotomy in surgical management of nephrolithiasis. Materials and Methods. We analyzed 16 laparoscopic pyelolithotomies performed in our clinic over the last few years for large and stag-horn stones of anomalous kidneys (n=8), the "giant" (>30-40 cc) monolithic stones of the large extrarenal pelvis (n=3), multiple stones of PCS with the stone burden of ≥ 40 cm3 (n=2) and large recurrent (after PCNL) kidney stones in patients at risk of bacteriotoxic complications of percutaneous nephroscopy (n=3). The age of the patients ranged from 39 to 72 years (mean age 51±8 years). The average density of stones was 1012 (160-1483) HU. Results. There were no conversions to open surgery. The mean operating time of laparoscopic pyelolithotomy was 137 (96-255) minutes, flexible transabdominal pyelocalycoscopy 31.2 (12-110) min. The stone-free rate was 87%. Residual clinically insignificant stones were found in two (13%) patients with staghorn horseshoe kidney calculi and complex PCS. The preoperative hospital stay was 1 day, postoperative-from 2 to 18 (mean 6) days. Discussion. We believe that laparoscopic pyelolithotomy supplemented by transabdominal flexible pyelocalycoscopy may be recommended for surgical management of patients with "giant", multiple and infected kidney stones, because the length of their percutaneous removal is beyond the recommended time intervals and it is accompanied by an increased risk of septic complications.

Толық мәтін

Рұқсат жабық

Авторлар туралы

P. Glybochko

I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University)

Email: rektorat@mma.ru
Academician of the RAS, Dr.Med.Sci., Prof., Rector; Director of Research Institute for Uronephrology and Human Reproductive Health

Yu. Alyaev

I.M. Sechenov First MSMU of Minzdrav of Russia

Email: ugalyaev@mail.ru
Corr. -Member of the RAS, Dr.Med.Sci., Prof., Head of Department of Urology; Director of the Urology Clinic

L. Rapoport

I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University)

Email: leonidrapoport@yandex.ru
Dr.Med.Sci., Professor at the Department of Urology; Deputy Director for Clinical Care of the Research Institute for Uronephrology and Human Reproductive Health

M. Enikeev

I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University)

Email: enikmic@mail.ru
Dr.Med.Sci., Head of the 2nd Department of the Urology Clinic, Professor at the Department of Urology

D. Tsarichenko

I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia (Sechenov University)

Email: tsarichenkodg@yandex.ru
Ph.D., M.D., Professor at the Department of Urology

E. Shpot

I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University)

Email: shpot@inbox.ru
Ph.D., Associate Professor at the Department of Urology

D. Korolev

I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University)

Email: demix84@inbox.ru
Urologist, Ph.D. Student at the Research Institute for Uronephrology and Human Reproductive Health

A. Vorobyev

I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University)

Urologist, Ph.D. Student at the Urology Clinic

D. Enikeev

I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University)

Email: enikeev_dv@mail.ru
Deputy Director for Science, Research Institute of Uronephrology and Human Reproductive Health

Әдебиет тізімі

  1. Sahinkanat T., Ekerbicer H., Onal B., Tansu N., Resim S., Citgez S., Oner A. Evaluation of the effects of relationships between main spatial lower pole calyceal anatomic factors on the success of shock wave lithotripsy in patients with lower pole kidney stones. Urology. 2008;71:801.
  2. Türk C., Petrik A., Sarica K., Seitz C., Skolarikos A., Straub M., Knoll T. EAU Guidelines on Interventional Treatment for Urolithiasis. Eur Urol. 2016;69:475.
  3. Schnabel M.J., Gierth M., Chaussy C.G., Dötzer K., Burger M., Fritsche H.M. Incidence and risk factors of renal hematoma: a prospective study of 1,300 SWL treatments. Urolithiasis. 2014;42:247.
  4. Cormio L., Gonzalez G.I., Tolley D., Sofer M., Muslumanoglu A., Klingler H.C., Stolzenburg J.U., de la Rosette J. Exit strategies following percutaneous nephrolithotomy (PCNL): a comparison of surgical outcomes in the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study. World J Urol. 2013;31:1239.
  5. Garofalo M., Pultrone C.V., Schiavina R., Brunocilla E., Sanguedolce F., Borghesi M., Rocca C., Del Prete C., Morselli-Labate A.M., Paccapelo A., Martorana G. Tubeless procedure reduces hospitalization and pain after percutaneous nephrolithotomy: results of a multivariable analysis. Urolithiasis. 2013;41:347.
  6. Zheng C., Xiong B., Wang H., Luo J., Zhang C., Wei W., Wang Y. Retrograde intrarenal surgery versus PCNL for treatment of renal stones > 2 cm a meta-analysis. Urol Int. 2014;93:417.
  7. Hyams E.S., Munver R., Bird V.G., Uberoi J., Shah O. Flexible ureterorenoscopy and holmium laser lithotripsy for the management of renal stone burdens that measure 2 to 3 cm: a multi-institutional experience. J Endourol. 2010;24:1583.
  8. Riley J.M., Stearman L., Troxel S. Retrograde ureteroscopy for renal stones larger than 2.5 cm. J Endourol. 2009;23:1395.
  9. Honeck P., Wendt-Nordahl G., Krombach P., Bach T., Häcker A., Alken P., Michel M.S. Does open stone surgery still play a role in the treatment of urolithiasis? Data of a primary urolithiasis center. J Endourol. 2009;23:1209.
  10. Bichler K.H., Lahme S., Strohmaier W.L. Indications for open stone removal of urinary calculi. Urol Int. 1997;59:102.
  11. Skolarikos A., Papatsoris A.G., Albanis S., Assimos D. Laparoscopic urinary stone surgery: an updated evidence-based review. Urol Res. 2010;38:337.
  12. Simforoosh N., Aminsharfi A. Laparoscopic management in stone disease. Curr Opin Urol. 2013;23(2):169-174.
  13. Garcua-Seguu А., Gascyn-Mir M. Nephroscopy with carbon dioxide in combination with laparoscopy in the treatment of urinary stones. Actas Urol Esp. 2012;36(3):186-190.
  14. Whelan J.P., Wiesenthal J.D. Laparoscopic pyeloplasty with simultaneous pyelolithotomy using a flexible ureteroscope. Can J Urol. 2004;11:2207-2209.

Қосымша файлдар

Қосымша файлдар
Әрекет
1. JATS XML
Жүктеу

© Bionika Media, 2017

Осы сайт cookie-файлдарды пайдаланады

Біздің сайтты пайдалануды жалғастыра отырып, сіз сайттың дұрыс жұмыс істеуін қамтамасыз ететін cookie файлдарын өңдеуге келісім бересіз.< / br>< / br>cookie файлдары туралы< / a>