Mini-percutaneous nephrolithotomy in surgery of nephrolithiasis

Sahalevych, A. I.; Sergiychuk, Roman; Ozhohin, V. V.; Vozianov, S.O.; Khrapchuk, Andriy; Dubovyi, Yaroslav; Frolov, O.

doi:10.31450/ukrjnd.3(71).2021.06

Cited by 4 publications

(4 citation statements)

References 25 publications

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“…Staghorn nephrolithiasis is known as a severe form of urolithiasis, the surgical treatment of which is characterized by a high rate of complications and the need for second-look interventions in order to completely remove stones from the kidney. Despite the high rate of complications when performing PNL, which varies from 29 % to 83 % [29], depending on the diameter of the nephroscope tube, the number of percutaneous accesses and handling skills [30], PNL remains the "gold standard" of surgical treatment of staghorn renal stones today [13,14].…”

Section: Resultsmentioning

confidence: 99%

The use of endoscopic combined intrarenal surgery in the treatment of nephrolithiasis

Postol

Sahalevych²,

Serhiichuk³

et al. 2022

ZMJ

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Urolithiasis is one of the most common urological conditions (30–45 %), peaking in the 4th–6th decades of life. About 50 % of patients have one recurrent episode of nephrolithiasis during their lifetime, and among the operated patients, more than 10–15 % of individuals report recurrences with the need for repeated surgical treatment. Increasing the incidence of nephrolithiasis in the world requires the development of new and improvement of existing methods of surgical treatment, which would be characterized by a high level of efficiency and low invasiveness with minimal complications and postoperative rehabilitation. The use of a combination of percutaneous nephrolithotripsy and flexible ureteronephrolithotripsy, especially in complex cases of urolithiasis, can increase the safety and improve the treatment of nephrolithiasis by combining the positive qualities of both methods. Aim. To summarize the data of the world scientific literature on the treatment of nephrolithiasis by studying a combination of percutaneous nephrolithotripsy and retrograde or antegrade flexible intrarenal surgery based on the evaluation of their effectiveness and safety. Materials and methods. The literature review was conducted using the databases PubMed, Google Scholar, Web of Science and Scopus for the period 2015–2022. The following keywords were used for the search: surgical treatment of nephrolithiasis, endoscopic combined intrarenal surgery (ECIRS), percutaneous nephrolithotomy, retrograde intrarenal surgery, simultaneous use of flexible ureterorenoscopy and percutaneous nephrolithotomy, simultaneous use of flexible ureterorenoscopy and percutaneous nephrolithotripsy. Conclusions. The use of ECIRS increases the effectiveness of one-stage treatment of nephrolithiasis with minimal complications and reduces the number of re-operations required. Treatment of complex forms of nephrolithiasis may be a priority for ECIRS. The main disadvantages of ECIRS are the need for simultaneous operation of two operating surgeons and the availability of two sets of endoscopic equipment, which make this procedure expensive.

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Section: Resultsmentioning

confidence: 99%

The use of endoscopic combined intrarenal surgery in the treatment of nephrolithiasis

Postol

Sahalevych²,

Serhiichuk³

et al. 2022

ZMJ

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“…Черезшкірна нефролітотрипсія є мінімально інвазивною операцією, однак у дослідженнях було повідомлено про виникнення сепсису від 0,3% випадків, і він є найбільш поширеною причиною смертності післяопераційних хворих [9,38,39,41,48,49]. Лікування пацієнтів з цією патологією слід проводити в умовах реанімаційного відділення під постійним моніторингом.…”

Section: інфекційні ускладненняunclassified

Complications of Percutaneous Nephrolithotripsy (Literature Review)

Roman

2021

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Percutaneous nephrolithotripsy is a standard treatment option for upper urinary tract stones ≥1.5 cm in size, multiple and staghorn stones. The efficiency and reliability of this procedure have improved, because of advances in technology and increased experience. This operation is considered a safe technique, which have the highest level of stone-free rate in comparison with shock-wave lithotripsy and retrograde nephrolithotripsy. The percutaneous nephrolithotripsy does not rule out the risk of complications. To analyze the complications of percutaneous nephrolithotripsy, their risk factors and treatment methods based on overview of scientific literature. It was identified the following complications such as bleeding during surgery and postoperatively, perforation of the renal collecting system, chest injuries, spleen injuries, liver and gallbladder injuries, injuries of the small and large intestine, and also infectious complications. The risk factors such as stone size and stone location, renal syntopia and skeletotopia, urinary system abnormalities, and overweight affect were established. Preoperative leukocytosis, positive urinary nitrite, and positive bacteriological culture of bladder urine are independent risk factors for infectious complications after percutaneous nephrolithotripsy, especially in patients with diabetes mellitus. Percutaneous nephrolithotripsy is the most difficult technique for treating urolithiasis. Therefore, the training of this operation is long and difficult. It is established that competence and perfection are achieved after 45 and 105 operations, respectively. Adequate preoperative preparation, especially elimination of urinary tract infection before surgery, accurate puncture under the guidance of fluoroscopy and / or ultrasound, maintenance of low intrarenal pressure and reduction of surgery time are important technical requirements for safety and efficacy of percutaneous nephrolithotripsy. According to the literature, percutaneous nephrolithotripsy is an effective and safe method of treating nephrolithiasis with a low level of complications. Knowledge of risk factors, treatment methods is important for every endourologist. Most complications, with timely diagnosis, can be eliminated conservatively, or with minimal invasive techniques, which has a positive effect on the treatment time and the psycho-emotional state of the surgeon.

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“…Ще однією відмінністю міні-ПНЛ від традиційної ПНЛ є практично повна відсутність необхідності застосування літоекстракторів. Фрагменти каменю евакуюються самостійно з потоком рідини через кожух, що відповідає принципу гідродинаміки Бернуллі, який найбільш ефективно працює при розмірах тракту [13][14][15][16][17][18]28].…”

Section: рулт/ф-рулт проти аултunclassified

“…Хоча деякі автори притримуються думки, що інтрата постопераційний біль більшою мірою спричинений інтраопераційною тракцією нирки при ПНЛ чи підвищенням внутрішньониркового тиску піл час РІРХ, аніж проколом, розсіченням та дренуванням нефростомою [28]. Доказом того також є робота Ding et al із вивчення прозапальних білків, яка доводить, що трав-матизація ниркової паренхіми при ПНЛ не впливає на інтра-та післяопераційний біль [41].…”

Section: рулт/ф-рулт проти аултunclassified

Modern Methods of Treatment for Proximal Ureterolithiasis

Ozhohin

2021

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Urolithiasis is a disease characterized by the formation of stones in the urinary tract. According to statistics, SCC causes about 30% of hospitalizations in the urology department. Treatment of SCC is divided into conservative and operative. The choice of method depends on age, clinical course of the disease, general condition of the patient, anatomical and functional condition of the kidneys and the size of the localization of the calculus. Methods of treatment of SC have changed significantly in recent years. Due to the technical achievements of the method of open ureterolithotomy, which was once the standard method of treatment of so-called «complicated» concretions of the ureter, evolved into a laparoscopic ureterolithotomy, and with the advent of ultrasonic and laser lithotriptors – began the newest era of minimally invasive urology– extracorporeal shock-wave lithotripsy and endourology: antegrade percutaneous ureterolithotripsy, retrograde ureteroscopic lithotripsy and flexible retrograde uretherolithotripsy (FURS). The purpose of the work – on the basis of scientific literature to assess the effectiveness, safety and profitability of modern methods of surgical treatment for proximal ureterolithiasis. During the scientific research, attention was paid to the following parameters: stone free rate (SFR), postoperative pain level, need for painkillers, number of postoperative bed-days, presence of postoperative fever, hemoglobin level, need for blood transfusion, and on the economic component during the implementation of a technique. The principles of treatment of patients with large proximal ureterolithiasis are described in the clinical guidelines of the European and American Associations of Urologists. However, for example, which of the 3 proposed methods of treatment of large proximal ureterolithiasis to choose – there is no consensus from the world urological community. Percutaneous antegrade ureterolithotripsy is the preferred method of choice in patients with large proximal ureteral stones that cannot be removed by contact or extracorporeal ureterolithotripsy, characterized by a high level of absence of stones and minimal complications, optimal post operative and high indicators of economic attractiveness of this technique.

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Mini-percutaneous nephrolithotomy in surgery of nephrolithiasis

Cited by 4 publications

References 25 publications

The use of endoscopic combined intrarenal surgery in the treatment of nephrolithiasis

The use of endoscopic combined intrarenal surgery in the treatment of nephrolithiasis

Complications of Percutaneous Nephrolithotripsy (Literature Review)

Modern Methods of Treatment for Proximal Ureterolithiasis

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