THE USE OF A HYBRID SURGICAL METHOD IN THE TREATMENT OF DESTRUCTIVE PYELONEPHRITIS

Abstract

The purpose of the study: to determine the possibility of applying this approach in the treatment of destructive forms of acute pyelonephritis.Material and methods: The article presents the experience of treating patient K. 18 years old, with a diagnosis of destructive pyelonephritis on the right on the basis of the Department of Urology No. 2 of the Regional Clinical Hospital (Barnaul), in the period from 25.12.21. to 09.01.22 An analysis of the state of renal function was carried out using multispiral computed tomography (MSCT) with bolus contrast before surgery and in the postoperative period with an assessment of laboratory data, duplex of kidney vessels, morphological examination of the material. Minimally invasive organpreserving surgery was performed in the volume of retroperitoneoscopic sanitation of foci of kidney destruction with drainage of the retroperitoneal space and drug correction of kidney circulation by endovascular access.Results: When conducting MSCT of the kidney with contrast, a significant role of tissue perfusion in the pathogenesis of destructive acute pyelonephritis is determined. Within the framework of the early postoperative period, there was a significant positive trend in MSCT. Morphological examination revealed signs of edema and leukocyte infiltration with an admixture of macrophages, dilated peritubular capillaries, in the lumen of which platelet aggregates were observed, completely filling the lumen.Conclusions: Preservation of the kidney, as well as complete restoration of lost renal function, indicates the feasibility of using a similar approach in this category of patients.