MINAMALLY INVASIVE MULTIPERCUTANEOUS ACCESS IN TREATMENT OF STAGHORN NEPHROLITHIASIS

This study aimed to assess safety and efficacy of minimally invasive percutaneous surgical techniques in patients with staghorn nephrolithiasis. The technique was a combination of a routine percutaneous nephrolithotomy (PCNL) and a multipercutaneous one. 55 patients with staghorn lithiasis who underwent a routine and multipercutaneous PCNL in urological clinic at I.M. Sechenov FMSMU were enrolled in the study. Amplatz Dilators (28-30 Ch), nephroscopes (24, 26 Ch), an ultrasound lithotripter were used for a routine PCNL while mininephroscopes (12 Ch) with tubes (11 Ch), a laser lithotripter were used for a multipercutanous procedure. 2 nephrostomic tracts were created in 48 (87,3%) patients, 3 - in 6 (10,9%), 4 (1,8%) in one patients to completely remove all the fragments of a stone. In 47(85,5%) patients a stone-free state was reached after a single percutaneous procedure, in 6 patients renephroscopy was performed. In 2 other patients several residual stones were observed in isolated calyces. However, they required no further treatment. Intraoperative complications were registered in 3 patients, who underwent a re-nephroscopy in the postoperative period. 8 patients developed postoperative hyperthermia (over 380C). Apparently, a combination of a routine PCNL and a multipercutaneous nephrolithothomy is a safe and effective procedure.

коралловидный нефролитиаз, перкутанная (чрескожная) нефролитотомия, мультиперкутанный до-ступ, мини-перкутанная нефролитотомия, комбинированное лечение коралловидного нефролитиаза, staghorn nephrolithiasis, percutaneous nephrolithotomy, multipercutanous access, multipercutaneous PCNL, com- bined treatment of staghorn nephrolithiasis

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