Supracosteal drainage-free nephrolitotripsy: the experience of our center
https://doi.org/10.17238/2072-3180-2023-3-40-46
Abstract
Introduction. The use of supracosteal access when performing ITP provides the easiest access to the upper calyx and is recommended in the presence of complex kidney stones.
Purpose of the study. Identification of the safest and most effective approach to the implementation of PTDTs and determination of indications for unpaired PTDTs. Materials and methods of research. A retrospective analysis of the case histories of 56 patients who underwent supra-rib PNLT in the urological department of ChUZ "KB" RZD-Meditsina "in Krasnoyarsk from January 2018 to December 2022 was carried out. Drainage-free PNLT was performed in 42 patients out of 56 (75 %). In all cases, supracosteal access was performed, and in 20 patients, a second working channel was additionally formed in a standard position below the XII rib.
Treatment results. We evaluated the efficacy of PNLT for two groups of patients: the supracostal group without nephrostomy and the supracostal group with established nephrostomic drainage at the end of operative treatment. The results showed that the SFR for the supracostal group without nephrostomy was 90 %, while in the supracotsal group with external drainage this figure was 64 % (p < 0,05). The overall SFR in the study was 83,9 %. The overall complication rate was 12,5 %, with infectious-inflammatory complications most often occurring, which were managed conservatively.
Conclusion. Supra-rib LAFT can be a safe and effective procedure with careful anatomical positioning, adequate puncture of the renal cavity system and an experienced operator.
About the Authors
A. G. Berezhnoy
V.F. Voino-Yasenetsky Krasnoyarsk State Medical University; Road hospital at the station Krasnoyarsk Russian Railways
Russian Federation
Russian Federation
Alexander G. Berezhnoy – Doctor of Medical Sciences, Professor, FSBEI HE “Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky“.
660022, st. Partizan Zheleznyak, 1, Krasnoyarsk
S. S. Dunaevskaya
V.F. Voino-Yasenetsky Krasnoyarsk State Medical University; Road hospital at the station Krasnoyarsk Russian Railways
Russian Federation
Russian Federation
Svetlana S. Dunaevskaya – Doctor of Medical Sciences, Professor, FSBEI HE “Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky“.
660022, st. Partizan Zheleznyak, 1, Krasnoyarsk
A. V. Ershov
V.F. Voino-Yasenetsky Krasnoyarsk State Medical University; Road hospital at the station Krasnoyarsk Russian Railways
Russian Federation
Russian Federation
Artem V. Ershov – Candidate of Medical Sciences, FSBEI HE “Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky“.
660022, st. Partizan Zheleznyak, 1, Krasnoyarsk
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Review
For citations:
Berezhnoy A.G., Dunaevskaya S.S., Ershov A.V. Supracosteal drainage-free nephrolitotripsy: the experience of our center. Moscow Surgical Journal. 2023;(3):40-46. (In Russ.) https://doi.org/10.17238/2072-3180-2023-3-40-46
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