Оптимизация методов эндоскопической хирургии нефролитиаза

Аннотация

The aim of the research work is improvement of the results of endoscopic interventions in patients with nephrolithiasis by improving existing and developing new optimal methods of endoscopic surgery. 1 he scientific novelty ot the research consists ot following: The needle method with using multiple access percutaneous nephrolithotripsy was developed for endoscopic treatment of patients with staghorn and multiple nephrolithiasis which allows removing small stones and/or their disintegrated fragments located in inaccessible calyx; a method of simultaneous percutaneous nephrolithotripsy was developed, which allows simultaneous removal of two or more stones located in different parts of the upper urinary tract (in the kidney and ureter), to reduce the number of surgical interventions and anesthesia, the terms of treatment and patients’ rehabilitation period; a method of non-pcrcutaneous percutaneous nephrolithotripsy has been developed, which allows to reduce the frequency of postoperative infectious compliations, to improve the quality of life of patients in the postoperative period; it is confirmed that the criteria for the possibility of using non-stcrilc methods of percutaneous nephrolithotripsy arc: absence of intraoperative complications (perforation, bleeding), complete liberation from stones and absence of organic obstruction of the upper urinary tract; an objective assessment was conducted of postoperative complications the improved methods (multiple access, simultaneous and tubeless) of endoscopic treatment of nephrolithiasis with the help of the optimally adapted classification of surgical complications of Clavien-Dindo;