COMPARATIVE ANALYSIS OF THE EFFECTIVENESS OF NON-INVASIVE METHODS OF TREATMENT OF NON-DENDRITIC KIDNEY STONES
Donetsk National Medical University, Liman, Ukraine
Currently, extracorporeal shock−wave lithotripsy is the first−choice method for treating kidney stones of a small size. However, the limited capabilities of this operation have prompted researchers to seek new, more effective methods, in particular in the clinical practice they began to actively apply fibroureteroenoscopy in combination with laser nephrolithotripsy, the technique of percutaneous nephrolithotripsy. To conduct a comparative analysis of the results of treatment with the use of different low−invasive technologies and to determine the tactics of the treatment of concretions of different magnitudes, a study involving more than a thousand patients was conducted. The obtained data made it possible to draw conclusions about the effectiveness of treatment of non−corneal kidney stones. Thus, the use of extracorporeal shock−wave lithotripsy is effective in patients with concrements of 6−10 mm and a density of not more than 1000 HU, fibroureteronoscopy in combination with laser nephrolithotripsy is justified by stones smaller than 1 cm and a density greater than 1000 HU, as well as any density at sizes up to 27 mm, the mini−percutaneous nephrolithotripsy is successfully applied at concrements from 17 to 27 mm. At the same time it was emphasized that the use of minimally invasive methods in patients with stones over 30 mm leads to an unjustified increase in the duration of operation and the increase in the frequency of complications.
Key words: non−dendritic kidney stones, extracorporeal shock wave lithotripsy, fibroureterorenoscopy, mini percutaneous nephrolithotripsy.