Multicenter study of surgical treatments of urolithiasis according to the National Register of surgical treatment of urolithiasis

Gadzhiev, Nariman; Grigoriev, V.E.; Bakhtin, M Yu; Pisarev, Alexey; Tagirov, Nair S.; Obidnyak, V M; Gorelov, Dmitry; Петров, С. Б.; Mazurenko, D.A.; Kurnikov, D.A.

doi:10.29188/2222-8543-2019-11-4-14-18

Cited by 2 publications

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“…At the same time, our data are consistent with the results of similar studies carried out by both domestic and foreign researchers. For example, in a multicenter study by Gadzhiev et al [21], postoperative fever was observed in 6.3% of patients after percutaneous nephrolithotomy, development of urosepsis was noted in 1.01% of cases.…”

Section: Discussionmentioning

confidence: 98%

Controlled Fragmentation of Urinary Stones as a Method of Preventing Inflammatory Infections in the Treatment of Urolithiasis (Experience in Successful Clinical Use)

Streltsova¹,

Vlasov²,

Grebenkin³

et al. 2021

Sovrem Tehnol Med

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The introduction of technologically advanced methods of lithotripsy into medical practice changes the nature of postoperative complications. Among them, the main complications are inflammatory infections. This largely determines the search for new, improved methods of stone fragmentation avoiding small stone fragments and dissemination of the pelvicalyceal system of the kidney with stoneassociated infection. The authors have developed a method for controlled stone fragmentation using a continuous-wave diode laser with a hot-spot effect at the optical fiber end.The aim of the study was to evaluate the efficacy of controlled urinary stone fragmentation using a continuous-wave diode laser with a highly heated distal end of the optical fiber light guide as a method of preventing inflammatory infections in clinical practice.Materials and Methods. We analyzed 1666 case histories of urolithiasis patients who underwent percutaneous nephrolithotripsy/ nephrolithoextraction and contact ureterolithotripsy/ureteroextraction, we also performed a prospective analysis of complications based on the Clavien-Dindo classification in 90 patients who underwent fine fragmentation of stones with various lithotripters: ultrasonic, pneumatic, and holmium laser. The method of controlled stone fragmentation by a diode laser with a hot-spot effect was tested on postoperative samples of 26 renal calculi. For the first time in clinical practice, this method was tested in the bladder cavity (n=10).Results. In the percutaneous nephrolithotripsy group, postoperative infectious and inflammatory complications occurred in 34.1% of cases, in the percutaneous nephrolithoextraction group -in 24.6%, in the contact ureterolithotripsy group -in 7.8%, in the ureterolithoextraction group -in 2.5%. The analysis made it possible to identify factors promoting the development of infectious and inflammatory complications. For the first time in clinical practice, there were successfully performed ten operations of stone fragmentation using a continuous-wave diode laser with a hot-spot effect. Controlled coarse fragmentation of stones providing the possibility to reduce the number of infectious and inflammatory complications was performed in the bladder as a model for testing the method.Conclusion. The method of laser-induced controlled coarse fragmentation of stones with a hot-spot effect, developed and tested in clinical practice, is promising for the prevention of infectious and inflammatory complications in patients with potentially infected stones since their fine fragmentation and, consequently, spread of stone-associated toxins and microflora within the urinary system is avoided.

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Section: Discussionmentioning

confidence: 98%

Controlled Fragmentation of Urinary Stones as a Method of Preventing Inflammatory Infections in the Treatment of Urolithiasis (Experience in Successful Clinical Use)

Streltsova¹,

Vlasov²,

Grebenkin³

et al. 2021

Sovrem Tehnol Med

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Retrograde intrarenal surgery in patients with high-density stones

Tursunov

Nazarov

Рычков

2022

Urology reports (St. - Petersburg)

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BACKGROUND: Retrograde intrarenal lithotripsy is a modern method of endoscopic treatment of patients with nephrolithiasis, whereas some aspects of its use remain the subject of discussion. AIM: To reveal the advantages and disadvantages of retrograde intrarenal lithotripsy in patients with nephrolithiasis having high-density calculi. MATERIALS AND METHODS: A retrospective and prospective analysis of treatment of 260 clinical cases of high-density kidney stones by transurethral contact pyelocalicolithotripsy was conducted. In all patients, kidney calculi were diagnosed and detected, ranging in size from 8 to 20 mm (average 15.4 mm) and density from 1105 to 1634 HU. Patients were divided into the main group and control group and further into two subgroups according to the lithotripsy method. The main group underwent transurethral contact pyelocalicolithotripsy according to our improved method and the control group according to the standard method. The main subgroup of ultrasonic lithotripsy and the control subgroup included 80 and 50 patients, respectively. The main subgroup of laser lithotripsy and the control subgroup included 50 and 80 patients, respectively. RESULTS: In 223 (85.8%) patients, it was possible to completely crush the calculi and eliminate them from the urinary tract. The stone-free rate in the main group was 96.9% (126 patients) after the first operation, including 96.2% (n = 77) in the ultrasonic lithotripsy subgroup and 98% (n = 49) in the laser lithotripsy subgroup. In the control group, the SFR value was 74.6% (n = 97), including 72% (n = 36) in the ultrasonic lithotripsy subgroup and 83.2% (n = 61) in the laser lithotripsy subgroup. Intra- and postoperative complications were observed in 74 (28.5%) patients, and none had grade IV and V complications according to the adapted ClavienDindo classification. The frequency of complications was significantly lower in the main group and those who underwent laser lithotripsy. The relationship of postoperative complications with intraoperative damage to the structures of the pelvicalyceal system of the kidney has been established. CONCLUSIONS: Transurethral contact pyelocalicolithotripsy is an effective and relatively safe method of treating patients with nephrolithiasis having high-density calculi. The proposed improved surgical intervention has advantages over traditional methods.

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Multicenter study of surgical treatments of urolithiasis according to the National Register of surgical treatment of urolithiasis

Cited by 2 publications

References 0 publications

Controlled Fragmentation of Urinary Stones as a Method of Preventing Inflammatory Infections in the Treatment of Urolithiasis (Experience in Successful Clinical Use)

Controlled Fragmentation of Urinary Stones as a Method of Preventing Inflammatory Infections in the Treatment of Urolithiasis (Experience in Successful Clinical Use)

Retrograde intrarenal surgery in patients with high-density stones

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