Novosti
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This journal is indexed in Scopus |
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Year 2014 Vol. 22 No 6
UROLOGY
F.P. KAPSARGIN, E.V. DYABKIN, A.I. KORMILKIN, E.A. ALEXEEVA
A COMPARATIVE ASSESSMENT OF SURGICAL TREATMENT OF KIDNEY STONES
SBEE HPE “Krasnoyarsk State Medical University named after professor V.F. Voyno-Yasenetsky,
The Russian Federation
Objectives. To evaluate the clinical efficacy of various surgical treatment methods of nephrolithiasis.
Methods. The results of 267 nephrolithotomies within the period from 2007 to 2011 have been analyzed. The age of patients ranged from 21 to 75 years (48,2±3,5 years). For the purpose of representativeness 50% women and 50% men were included in the study.
All the patients depending on the method of surgical intervention were divided into 4 groups: 1) the traditional open surgery: pyelolithotomy or nephrolithotomy (63 patients), 2) percutaneous nephrolithoextraction – 83 patients, 3) extracorporeal shockwave lithotripsy (ESWL) (104 patients), and 4) combined minimally invasive interventions – 17 patients.
Results. It has been established the post-operative recovery period is usually much shorter by implementing minimally invasive intervention. Time of the retroperitoneal drainage in open surgeries made up 7,7±0,6 days, and in minilumbotomy – 6,2±0,34. After minimally invasive operations the reduction of leukocytes has been registered, whereas in patients after open nephrolithotomy an elevation of this indicator appeared to be on the third day. Duration of endoscopic intervention for kidney stones varied between 25 and 65 minutes (average 38,7±1,8 min). Blood loss was minimal (150,8±37,6) ml after percutaneous interventions and open surgery characterized by a significantly larger volume of blood loss (211,1±17,5 ml). Combined nephrolithotomy is indicated for large (more than 1,5-2,0 cm) and dense (1000 units HU or more) stones in intrarenal located pelvis.
Conclusion. As a result of our study it has been revealed that the use of a minimally invasive approach to treating and removing renal stones helps to reduce the average time of disability up 20 days. The percutaneous approach is commonly used in the case of certain contraindications to ESWL. The application of the proposed methods allows reducing recovery time.
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660022, Rossiyskaya Federatsiya,
g. Krasnoyarsk, ul. Partizana Zheleznyaka,
d. 1, GBOU VPO «Krasnoyarskiy gosudarstvennyiy meditsinskiy
universitet imeni professora V.F. Voyno-Yasenetskogo»,
kafedra obschey khirurgii,
tel. office: 7 (391) 208-99-26,
e-mail: dyabkyn@mail.ru,
Dyabkin Evgeniy Vladimirovich
Kapsargin F.P. MD, a head of the urology, andrology and sexology chair of SBEE HPE “Krasnoyarsk State Medical University named after Professor V.F. Voyno-Yasenetsky”.
Dyabkin E.V. PhD, an assistant of the general surgery chair of SBEE HPE “Krasnoyarsk State Medical University named after Professor V.F. Voyno-Yasenetsky”.
Kormilkin A.I. An applicant for Candidate’s degree of the urology, andrology and sexology chair of SBEE HPE “Krasnoyarsk State Medical University named after Professor V.F. Voyno-Yasenetsky”.
Alexeeva E.A. PhD, associate professor of the urology, andrology and sexology chair of SBEE HPE “Krasnoyarsk State Medical University named after professor V.F. Voyno-Yasenetsky”.
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