International Medical Journal, Vol. 25., Iss. 4, 2019, P. 40−43.
TREATMENT ADVANTAGES OF PATIENTS WITH URETEROLITHIASIS BY LITHOTRIPSY CONTACT METHODS IN COMPARISON WITH OPEN SURGERY
Danylo Halytsky Lviv National Medical University, Ukraine
One of the most effective methods of treatment of ureteral concretions is ureteroscopy with contact lithotripsy. The study analyzed the results of treatment of 96 patients with urolithiasis they were as follows: 44 patients underwent laser ureterolithotripsy, 52 persons had an open ureterolithotomy. When comparing different treatments for patients with ureterolithiasis, it has been found that the average duration of surgery when performing laser ureterolithotripsy was shorter and averaged 53 minutes. As for open ureterolithotomy it lasted in average 102 minutes. The average length of patients staying in clinic when performing laser ureterolithotripsy in average was 2.5 days, during open ureterolithotomy that index was 20 days. This is a significant advantage of endoscopic treatment of ureterolithiasis versus an open surgery (especially when a holmium laser is used in lithotripsy). By using endoscopic methods of treatment of ureteral concretions instead of an open surgery (ureterolithotomy), it has been possible to reduce the in−patient staying 8 times. Lithotripsy with a holmium laser occurred to be an effective method of destroying the ureteral concretions of any mineral composition, if the dimensions of these calculi did not exceed 2 cm. It should be emphasized that under these conditions, the localization of a stone and the duration of its stay in the ureter are also not important. In addition, the use of a holmium laser minimizes an injury to the ureter wall. The advantages of lithotripsy when it used with a holmium laser consist in its high efficiency in destruction of solid fixed and the ingrown stones. In case of combination of both a stone and ureteral stricture and in the presence of ligature calculi, the treatment with a holmium laser is also prescribed.
Key words: ureterolithiasis, laser ureterolithotripsy, open ureterolithotomy, holmium laser.
1. Safety and efficacy of holmium: YAG laser lithotripsy in patients with bleeding diatheses / J. Watterson, A. Girvan, A. Cook [et al.] // J. Urol.− 2002.− № 168.− P. 442−445. https://doi.org/10.1016/s0022−5347(05)64654−x
2. Borzhiyevskij A. C. Ureterolitiaz / A. C. Borzhiyevskij, S. O. Vozianov.− Lviv: NMU, 2007.− S. 5.
3. Bagley D. H. Ureteroscopic stone retrival: rigid versus flexible endoscopes / D. H. Bagley // Sem. Urol.− 1994.− Vol. 12.− P. 32.
4. Park H. Two−year experience with ureteral stones: Extracorporeal shockwave lithotripsy in ureteroscopic manipulation / H. Park, M. Park, T. Park // J. Endourol.− 1998.− № 12.− P. 501−504. https://doi.org/10.1089/end.1998.12.501
5. Ureteroscopy: effect of technology and technique of clinical practice / G. Chow, D. Patterson, M. Blute, J. Segura // J. Urol.− 2003.− № 170.− P. 99−102. https://doi.org/10.1097/01.ju.0000070883.44091.24
6. Golmievaya kontaktnaya litotripsiya v transuretralnom lechenii kamnej verhnih mochevyvodyashih putej / A. G. Martov, V. A. Maksimov, D. V. Erchakov [i dr.] // Urologiya.− 2008.− № 5.− S. 24−28.
7. Borzhiyevskij A. C. Endoskopichne kontaktne droblennya kameniv sechovodu lazerom / A. C. Borzhiyevskij, A. Z. Zhuravchak, R. Z. Sheremeta // Urologiya.− 2002.− № 4.− S. 39−43.
8. Transuretralnye endoskopicheskie operacii na mochetochnike / Yu. G. Alyaev, L. M. Rappoport, N. A. Grigorev [i dr.] // Hirurgiya.− 2006.− № 9.
9. DACVIM Laser Lithotripsy Using the Holmium / G. Larry [et al.] // YAG laser.− 2001.− P. 121.